Author + information
- Jiangjin Li,
- Haifeng Zhang,
- Hao Zhang,
- Yao Wang,
- Peibing Ge,
- Ningchao Tao,
- Xiaofeng Hou and
- Jiangang Zou
Background: Pulmonary vascular resistance (PVR) is an important predictor and determinant in patients with advanced heart failure. However, its significance in predicting response to cardiac resynchronization therapy (CRT) remains unclear. The study explored whether baseline PVR calculated through right heart catheter played a role in predicting response to CRT in patients with heart failure.
Methods: The study population was consisted of thirty-three patients with heart failure who received CRT. According to response to CRT, which was defined as a reduction in left ventricular end-systolic volume more than or equal to 15% after 6 months follow-up, patients were assigned to CRT responder group and CRT nonresponder groups. The PVR was estimated with right heart catheter (RHC) within 1 week before CRT and after 6-month follow-up. The relationship between baseline PVR with clinical and echocardiographic response to CRT was appraised using univariate and multivariate regression analysis test.
Results: 23 patients (69.7%) were CRT responders and 10 patients (30.3%) were CRT nonresponders. Compared with CRT nonresponders, CRT responders had lower baseline PVR values (4.58±2.83 vs 1.74±0.89 wood; P=0.011). Multivariate regression analysis showed that baseline PVR was an independent predictor for response to CRT (OR=5.234, 95%confidence interval [CL]: 1.384-19.788, P=0.015). The optimal cutoff of PVR to predict nonresponse to CRT was 2.95 wood, with a sensitivity of 70% and a specificity of 95.7% (95% CL: 0.778-1). Especially, in CRT nonresponders, 5 patients with the presence of clinical response but the absence of echocardiographic response to CRT demonstrated a significantly reduction of PVR (4.01±3.25 vs 1.38±1.21 wood; P=0.046) and mean pulmonary artery pressure (mPAP, 33.6±9.93 vs 24.8±14.69mmHg; P= 0.023).
Conclusions: The baseline PVR is associated with response to CRT and the elevated PVR could be an independent predictor of nonresponse to CRT.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Gadgets Galore
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1199-248
- 2017 American College of Cardiology Foundation