title: A new baseline scoring system may help to predict response to cardiac resynchronization therapy.
abstract: BACKGROUND
  The PROSPECT trial reported no single echocardiographic measurement of dyssynchrony is recommended to improve patient selection for cardiac resynchronization therapy (CRT).
  
  
  METHODS
  In 100 consecutive patients who received CRT, we analyzed 27 ECG and echocardiographic variables to predict a positive response to CRT defined as a left ventricular (LV) end systolic volume decrease of ≥ 15% after CRT.
  
  
  RESULTS
  Right ventricular (RV) pacing-induced left bundle branch block (LBBB), time difference between LV ejection measured by tissue Doppler and pulsed wave Doppler (T(TDI-PW)), and wall motion score index (WMSI) were significantly associated with positive CRT response by multivariate regression. We assigned 1 point for RV pacing-induced LBBB, 1 point for WMSI ≤ 1.59, and 2 points for T(TDI-PW) > 50 ms. Overall mean response score was 1.79 ±1.39. Cutoff point for response score to predict positive response to CRT was > 2 by receiver operating characteristic (ROC) analysis. Area under ROC curve was 0.97 (p = 0.0001). Cardiac resynchronization therapy responders in patients with response score > 2 and ≤ 2 were 36/38 (95%) and 7/62 (11%, p < 0.001), respectively. After age and gender adjustment, the response score was related to CRT response (OR = 45.4, p < 0.0001).
  
  
  CONCLUSIONS
  A response score generated from clinical, ECG and echocardiographic variables may be a useful predictor for CRT response. However, this needs to be validated.
authors.affiliation: Cardiac Center of Creighton University School of Medicine, Omaha, Nebraska, USA.
authors.forename: Xuedong
authors.initials: X
authors.lastname: Shen
authors.forename: Chandra K
authors.initials: CK
authors.lastname: Nair
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.forename: Mak J
authors.initials: MJ
authors.lastname: Holmberg
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy
authors.forename: Kishley
authors.initials: K
authors.lastname: Anand
authors.forename: Tom
authors.initials: T
authors.lastname: Hee
authors.forename: Aimin
authors.initials: A
authors.lastname: Chen
authors.forename: Xiang
authors.initials: X
authors.lastname: Fang
authors.forename: Stephanie
authors.initials: S
authors.lastname: Maciejewski
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Esterbrooks