title: A new score system for predicting response to cardiac resynchronization therapy.
abstract: BACKGROUND
  The aim of this study was to establish a score system derived from clinical, echocardiographic and electrocardiographic indexes and evaluate its clinical value for cardiac resynchronization therapy (CRT) patient selection.
  
  
  METHODS
  Ninety-three patients receiving CRT were enrolled. A patient selection score system was generated by the clinical, echocardiographic and electrocardiographic parameters achieving a significant level by univariate and multivariate Cox regression model. The positive response to CRT was a left ventricular end systolic volume decrease of ≥ 15% and not reaching primary clinical endpoint (death or re-hospitalization for heart failure) at the end of follow-up.
  
  
  RESULTS
  Thirty-nine patients were CRT non-responders (41.94%) and 54 were responders (58.06%). A 4-point score system was generated based on tricuspid annular plane systolic excursion (TAPSE), longitudinal strain (LS), and complete left bundle branch block (CLBBB) combined with a wide QRS duration (QRSd). The sensitivity and specificity for prediction of a positive response to CRT at a score > 2 were 0.823 and 0.850, respectively (AUC: 0.92295% CI 0.691-0.916, p< 0.001).
  
  
  CONCLUSIONS
  A patient selection score system based on the integration of TAPSE, LS and CLBBB combined with a wide QRSd can help to predict positive response to CRT effectively and reliably.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kang
authors.forename: Leilei
authors.initials: L
authors.lastname: Cheng
authors.forename: Jie
authors.initials: J
authors.lastname: Cui
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Shengmei
authors.initials: S
authors.lastname: Qin
authors.forename: Yangang
authors.initials: Y
authors.lastname: Su
authors.forename: Jialiang
authors.initials: J
authors.lastname: Mao
authors.forename: Xue
authors.initials: X
authors.lastname: Gong
authors.forename: Haiyan
authors.initials: H
authors.lastname: Chen
authors.forename: Cuizhen
authors.initials: C
authors.lastname: Pan
authors.forename: Xuedong
authors.initials: X
authors.lastname: Shen
authors.forename: Ben
authors.initials: B
authors.lastname: He
authors.affiliation: Department of echocardiography, Zhongshan hospital of Fudan university, Shanghai institute of cardiovascular disease, Shanghai, China. shu.xianhong@zs-hospital.sh.cn.
authors.forename: Xianhong
authors.initials: X
authors.lastname: Shu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000401:mortality; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003661:Decision Support Techniques; D019560:Echocardiography, Three-Dimensional; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission; D018579:Patient Selection; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome