A Novel and Simple Exercise Test Parameter to Assess Responsiveness to Cardiac Resynchronization Therapy
Alina-Ramona Cozlac1,2, Lucian Petrescu1,2, Simina Crisan1,2
1Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania.
Diagnostics (Basel, Switzerland)
|November 13, 2020
Summary
The heart rate recovery index (HRRI) from exercise tests can predict patient response to cardiac resynchronization therapy (CRT). A higher HRRI indicates a better outcome, aiding in treatment evaluation.
Area of Science:
- Cardiology
- Exercise Physiology
- Medical Diagnostics
Background:
- Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
- Predicting CRT response is crucial for patient management.
- Newer parameters for exercise testing are being explored to assess treatment efficacy.
Purpose of the Study:
- To evaluate the heart rate recovery index (HRRI) as a predictor of response to cardiac resynchronization therapy (CRT).
- To determine if HRRI can differentiate between CRT responders and non-responders.
Main Methods:
- Consecutive patients receiving CRT devices were followed for outcomes.
- Exercise tests (ET) were performed, measuring heart rate parameters.
- HRRI was calculated as acceleration time/deceleration time (AT/DT) and analyzed using logistic regression and ROC curves.
Main Results:
- HRRI was significantly higher in CRT responders (3.16 ± 2) compared to non-responders (1.4 ± 0.5) (p < 0.001).
- An HRRI cutoff of 1.51 demonstrated good predictive value (AUC = 0.844).
- Responders showed significant left-ventricular reverse remodeling and improved ejection fraction.
Conclusions:
- HRRI is a valuable, easily computable parameter from routine exercise tests.
- HRRI can effectively predict patient responsiveness to cardiac resynchronization therapy.
- This index aids in the clinical evaluation of CRT outcomes.
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