A patient selection score for cardiac resynchronization therapy

Xuedong Shen, Chandra K. Nair, Wilbert S. Aronow, Tom Hee, Suman Pasupuleti, Mark Jeffrey Holmberg, Fenwei Wang, Dennis J. Esterbrooks

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4 Scopus citations

Abstract

Background: We hypothesized a patient selection score (PSS) may improve patient selection for cardiac resynchronization therapy (CRT). Methods: Of 136 patients who received CRT, group A included 100 study patients and group B 36 patients for validation. A positive response to CRT was a left ventricular (LV) end-systolic volume decrease of ≥15% and survival from heart failure at end of follow-up. Results: Of 100 group A patients, 37 (37%) were CRT responders during 14-month follow-up. A 7-point PSS was generated based on six variables. The cutoff point for PSS to predict a positive response to CRT was >4 by receiver operating characteristic (ROC) analysis. The area under the ROC curve (AUC) for PSS to predict CRT response was 0.94 (P = 0.0001). CRT responders in patients with a PSS > 4 and 4 in Group B was also significantly higher compared to a PSS a;circ 4 (88% vs. 16%, P <0.001). The AUC for PSS to predict a CRT response in Group B was 0.91 (P = 0.0001). Conclusions: Patients with a PSS >4 are the most likely to respond to CRT. Using this score system, a PSS score >4 can predict the probability of a CRT response up to 88% in patients with heart failure and a wide QRS duration.

Original languageEnglish
Pages (from-to)188-195
Number of pages8
JournalEchocardiography
Volume28
Issue number2
DOIs
Publication statusPublished - Feb 2011
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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