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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...

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Autores principales: Liu, Xi, Hu, Yiran, Hua, Wei, Yang, Shengwen, Gu, Min, Niu, Hong-Xia, Ding, Li-Gang, Wang, Jing, Zhang, Shu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
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.
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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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