Related Experiment Video
Updated: May 12, 2026
10:39
Automated Contraction Analysis of Human Engineered Heart Tissue for Cardiac Drug Safety Screening
Published on: April 15, 2017
12.7K
In Silico Trials for Sex-Specific patient Inclusion Criteria in Cardiac Resynchronization Therapy: Advancing
Shuang Qian1, Devran Ugurlu2, Elliot Fairweather3
1National Heart and Lung Institute, Imperial College London, London, UK.
Arxiv
|June 5, 2025
Summary
Current cardiac resynchronization therapy (CRT) selection criteria inadequately represent females. Height-indexed QRS duration offers a more equitable approach for selecting patients, including women, for CRT.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Cardiac resynchronization therapy (CRT) guidelines rely on clinical trials with limited female participation.
- Left bundle branch block (LBBB) definitions and QRS duration (QRSd) criteria exhibit variable accuracy between sexes due to heart size and remodeling differences.
Purpose of the Study:
- To evaluate the impact of sex, heart size, LBBB, and conduction delay on QRS duration.
- To assess conventional and indexed QRSd criteria for diagnostic performance in CRT selection.
Main Methods:
- Electrophysiological simulations in 2627 UK Biobank participants and 359 ischemic heart disease patients.
- Modeling LBBB and conduction delay in healthy and diseased hearts.
- Analysis of conventional, indexed by LVEDV/LV mass, and height-indexed QRSd criteria.
Main Results:
- Conventional QRSd criteria under-selected LBBB females and over-selected non-LBBB patients.
- Indexing by LVEDV and LV mass reduced sex disparities but worsened non-LBBB over-selection.
- Height-indexed QRSd resolved sex differences and maintained low non-LBBB selection rates.
Conclusions:
- Height-indexed QRSd demonstrates superior performance for equitable CRT patient selection.
- This approach has the potential to improve CRT eligibility assessment, particularly for female patients.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...