First-Phase Ejection Fraction Predicts Response to Cardiac Resynchronization Therapy and Adverse Outcomes
Haotian Gu1, Baldeep S Sidhu2, Lingyun Fang1
1British Heart Foundation Centre, King's College London, London, United Kingdom.
JACC. Cardiovascular Imaging
|December 10, 2021
Summary
First-phase ejection fraction (EF1) effectively predicts response to cardiac resynchronization therapy (CRT). Higher EF1 values indicate a greater likelihood of positive outcomes and reduced heart failure rehospitalization after CRT.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) is vital for chronic heart failure, but up to 40% of patients do not respond.
- First-phase ejection fraction (EF1), a novel echocardiographic measure of early systolic function, may predict CRT response.
Purpose of the Study:
- To evaluate the predictive value of EF1 for CRT response.
- To assess EF1's role in predicting clinical outcomes post-CRT.
Main Methods:
- Retrospective analysis of 197 patients undergoing CRT (2009-2018).
- Validation cohort of 100 patients undergoing CRT.
- Analysis of volumetric response rate and clinical composite scores.
Main Results:
- EF1 in the highest tertile showed a 92.3% volumetric response rate vs. 12.1% in the lowest tertile (P < 0.001).
- A cutoff EF1 of 11.9% predicted CRT response with >85% sensitivity and specificity.
- EF1 was the strongest predictor of CRT response (OR: 1.56) and clinical improvement (OR: 1.11).
- Improved EF1 post-CRT predicted reduced heart failure rehospitalization and death (HR: 0.81).
Conclusions:
- EF1 is a strong predictor of response to cardiac resynchronization therapy.
- EF1 is a valuable tool for identifying patients likely to benefit from CRT.
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