E/A ratio before cardiac resynchronization therapy predicts left ventricle reverse remodeling.

Area of Science:

• Cardiology
• Medical Devices
• Heart Failure Management

Background:

• Cardiac Resynchronization Therapy (CRT) is indicated for heart failure patients.
• Approximately two-thirds of patients benefit from CRT, but responders are not well-identified.
• Predictive parameters for CRT response are needed to optimize patient selection.

Purpose of the Study:

• To evaluate the efficacy of CRT in heart failure patients.
• To identify echocardiographic parameters that predict CRT response.
• To assess long-term clinical improvements in CRT responders.

Main Methods:

• Retrospective analysis of 42 heart failure patients who underwent CRT between 2004 and 2009.
• Patients were evaluated pre-implant and during follow-up (mean 26.2 months) using echocardiography and ECG.
• CRT responders were defined by inverse left ventricle (LV) remodeling (≥10% reduction in LVEDD).

Main Results:

• CRT significantly improved echocardiographic parameters: LVEDD, ejection fraction (EF), mitral regurgitation (MR), and QRS duration.
• NYHA class also improved significantly post-CRT.
• 57% of patients (24/42) were classified as CRT responders based on inverse LV remodeling.
• A less severe basal E/A ratio was the only parameter statistically different between responders and non-responders (P=0.02).

Conclusions:

• CRT is effective in improving cardiac function and clinical status in a majority of heart failure patients.
• Improvements in CRT responders are sustained over long-term follow-up.
• A less severe E/A ratio is a significant predictor of positive response to CRT, indicated by reverse LV remodeling.