Author + information
- Valentina Kutyifa,
- Wojciech Zareba,
- Scott McNitt,
- Mehmet Aktas,
- Bela Merkely,
- Arthur Moss and
- Ilan Goldenberg
In MADIT-CRT, the benefit of cardiac resynchronization therapy with a defibrillator (CRT-D) among patients with QRS < 150 msec was observed only among females. We hypothesized that adjusting baseline QRS duration for body size and heart size may result in better identification of responders to CRT-D among males with QRS < 150 msec.
Baseline QRS duration was adjusted for baseline left ventricular end-diastolic volume (LVEDV) indexed by body surface area (QRS/LVEDVi), dichotomized at 75th percentile. The primary end point of this analysis was heart failure (HF) or death. Echocardiographic response to CRT-D was defined as percent change in LVEDV and LVESV at 12-month follow-up.
The novel parameter was evaluated in 1367 males, 336 of them had QRS/LVEDVi ≥ 1.5. Stratifying male patients by QRS/LVEDVi diminished the previously described significant QRS-by-treatment interaction of 0.007. Thus, CRT-D treatment was associated with a similar risk reduction of HF/Death in male patients with QRS/LVEDVi ≥ 1.5 and among those with QRS/LVEDVi < 1.5 (HR= 0.74 and 0.80, respectively; p-value for interaction= 0.17). Differences in echocardiographic response to CRT-D shown in subgroups by QRS were not seen in male patients stratified by
Using the novel parameter of QRS adjusted for body size and heart size in males results in better identification of responders to CRT-D.
Oral Contributions West, Room 2006
Saturday, March 09, 2013, 8:30 a.m.-8:45 a.m.
Session Title: Resynchronization Therapy and Right Ventricular Function
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 906-5
- 2013 American College of Cardiology Foundation