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A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
OBJECTIVES: It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. METHODS: We retrospectively reviewed 387 CRT patients. Multivariate logisti...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474763/ https://www.ncbi.nlm.nih.gov/pubmed/32908692 http://dx.doi.org/10.1155/2020/3856294 |
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author | Liu, Xi Hu, Yiran Hua, Wei Yang, Shengwen Gu, Min Niu, Hong-Xia Ding, Li-Gang Wang, Jing Zhang, Shu |
author_facet | Liu, Xi Hu, Yiran Hua, Wei Yang, Shengwen Gu, Min Niu, Hong-Xia Ding, Li-Gang Wang, Jing Zhang, Shu |
author_sort | Liu, Xi |
collection | PubMed |
description | OBJECTIVES: It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. METHODS: We retrospectively reviewed 387 CRT patients. Multivariate logistic regression analysis was performed to identify predictors for super-response (defined as an absolute increase in left ventricular ejection fraction of ≥15% at 6-month follow-up) and to create a score model. Multivariate Cox proportional-hazard regression analysis was conducted to assess associations with the long-term endpoint (defined as cardiac death/heart transplant, heart failure (HF) hospitalization, or all-cause death) across the score categories at follow-up. RESULTS: Among 387 patients, 109 (28.2%) met super-response. In multivariable analysis, 5 independent predictors (QQ-LAE) were identified: prior no fragmented QRS (odds ratio (OR) = 3.10 (1.39, 6.94)), QRS duration ≥170 ms (OR = 2.37 (1.35, 4.12)), left bundle branch block (OR = 2.57 (1.04, 6.37)), left atrial diameter <45 mm (OR = 3.27 (1.81, 5.89)), and left ventricular end-diastolic dimension <75 mm (OR = 4.11 (1.99, 8.48)). One point was attributed to each predictor, and three score categories were identified. The proportion of super-response after 6-month CRT implantation in patients with scores 0–3, 4, and 5 was 14.6%, 40.3%, and 64.1%, respectively (P < 0.001). Patients with score 5 had an 88% reduction in the risk of cardiac death/heart transplant (P=0.042), a 71% reduction in the risk of HF hospitalization (P=0.048), and an 89% reduction in the risk of all-cause mortality (P=0.028) compared to patients with scores 0–3. CONCLUSIONS: The QQ-LAE score can be used for prediction of super-response to CRT and selection of most suitable patients in clinical practices. |
format | Online Article Text |
id | pubmed-7474763 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-74747632020-09-08 A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score Liu, Xi Hu, Yiran Hua, Wei Yang, Shengwen Gu, Min Niu, Hong-Xia Ding, Li-Gang Wang, Jing Zhang, Shu Cardiol Res Pract Research Article OBJECTIVES: It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. METHODS: We retrospectively reviewed 387 CRT patients. Multivariate logistic regression analysis was performed to identify predictors for super-response (defined as an absolute increase in left ventricular ejection fraction of ≥15% at 6-month follow-up) and to create a score model. Multivariate Cox proportional-hazard regression analysis was conducted to assess associations with the long-term endpoint (defined as cardiac death/heart transplant, heart failure (HF) hospitalization, or all-cause death) across the score categories at follow-up. RESULTS: Among 387 patients, 109 (28.2%) met super-response. In multivariable analysis, 5 independent predictors (QQ-LAE) were identified: prior no fragmented QRS (odds ratio (OR) = 3.10 (1.39, 6.94)), QRS duration ≥170 ms (OR = 2.37 (1.35, 4.12)), left bundle branch block (OR = 2.57 (1.04, 6.37)), left atrial diameter <45 mm (OR = 3.27 (1.81, 5.89)), and left ventricular end-diastolic dimension <75 mm (OR = 4.11 (1.99, 8.48)). One point was attributed to each predictor, and three score categories were identified. The proportion of super-response after 6-month CRT implantation in patients with scores 0–3, 4, and 5 was 14.6%, 40.3%, and 64.1%, respectively (P < 0.001). Patients with score 5 had an 88% reduction in the risk of cardiac death/heart transplant (P=0.042), a 71% reduction in the risk of HF hospitalization (P=0.048), and an 89% reduction in the risk of all-cause mortality (P=0.028) compared to patients with scores 0–3. CONCLUSIONS: The QQ-LAE score can be used for prediction of super-response to CRT and selection of most suitable patients in clinical practices. Hindawi 2020-08-28 /pmc/articles/PMC7474763/ /pubmed/32908692 http://dx.doi.org/10.1155/2020/3856294 Text en Copyright © 2020 Xi Liu et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Liu, Xi Hu, Yiran Hua, Wei Yang, Shengwen Gu, Min Niu, Hong-Xia Ding, Li-Gang Wang, Jing Zhang, Shu A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
title | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
title_full | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
title_fullStr | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
title_full_unstemmed | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
title_short | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
title_sort | predictive model for super-response to cardiac resynchronization therapy: the qq-lae score |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474763/ https://www.ncbi.nlm.nih.gov/pubmed/32908692 http://dx.doi.org/10.1155/2020/3856294 |
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