Association of persistent or worsened echocardiographic dyssynchrony with unfavourable clinical outcomes in heart failure patients with narrow QRS width: a subgroup analysis of the EchoCRT trial.
Identifieur interne : 002431 ( PubMed/Corpus ); précédent : 002430; suivant : 002432Association of persistent or worsened echocardiographic dyssynchrony with unfavourable clinical outcomes in heart failure patients with narrow QRS width: a subgroup analysis of the EchoCRT trial.
Auteurs : John Gorcsan ; Peter Sogaard ; Jeroen J. Bax ; Jagmeet P. Singh ; William T. Abraham ; Jeffrey S. Borer ; Kenneth Dickstein ; Daniel Gras ; Henry Krum ; Josep Brugada ; Michele Robertson ; Ian Ford ; Johannes Holzmeister ; Frank RuschitzkaSource :
- European heart journal [ 1522-9645 ] ; 2016.
English descriptors
- KwdEn :
- Arrhythmias, Cardiac (mortality), Arrhythmias, Cardiac (physiopathology), Arrhythmias, Cardiac (therapy), Cardiac Resynchronization Therapy (methods), Echocardiography, Doppler, Color, Electrocardiography, Female, Follow-Up Studies, Heart Failure (mortality), Heart Failure (physiopathology), Heart Failure (therapy), Hospitalization, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Treatment Outcome, Ventricular Dysfunction, Left (mortality), Ventricular Dysfunction, Left (physiopathology), Ventricular Dysfunction, Left (therapy).
- MESH :
- methods : Cardiac Resynchronization Therapy.
- mortality : Arrhythmias, Cardiac, Heart Failure, Ventricular Dysfunction, Left.
- physiopathology : Arrhythmias, Cardiac, Heart Failure, Ventricular Dysfunction, Left.
- therapy : Arrhythmias, Cardiac, Heart Failure, Ventricular Dysfunction, Left.
- Echocardiography, Doppler, Color, Electrocardiography, Female, Follow-Up Studies, Hospitalization, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Treatment Outcome.
Abstract
EchoCRT was a randomized trial of cardiac resynchronization therapy (CRT) in severely symptomatic heart failure (HF) patients with narrow QRS width <130 ms, ejection fraction ≤35%, and echocardiographic dyssynchrony. All received CRT implants which were then randomized to CRT-On or CRT-Off. While the trial showed no benefit of CRT to these patients, the aim of this subgroup analysis was to test the hypothesis that persistent or worsening dyssynchrony is associated with unfavourable clinical outcomes.
DOI: 10.1093/eurheartj/ehv418
PubMed: 26321238
Links to Exploration step
pubmed:26321238Le document en format XML
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Bax</name><affiliation><nlm:affiliation>Leiden University Medical Center, Leiden, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Singh, Jagmeet P" sort="Singh, Jagmeet P" uniqKey="Singh J" first="Jagmeet P" last="Singh">Jagmeet P. Singh</name><affiliation><nlm:affiliation>Massachusetts General Hospital, Harvard Medical School, Boston, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Abraham, William T" sort="Abraham, William T" uniqKey="Abraham W" first="William T" last="Abraham">William T. Abraham</name><affiliation><nlm:affiliation>Division of Cardiovascular Medicine, Ohio State University Medical Center, Davis Heart and Lung Research Institute, Columbus, USA gorcsanj@upmc.edu.</nlm:affiliation></affiliation></author><author><name sortKey="Borer, Jeffrey S" sort="Borer, Jeffrey S" uniqKey="Borer J" first="Jeffrey S" last="Borer">Jeffrey S. Borer</name><affiliation><nlm:affiliation>Department of Cardiology, Division of Cardiovascular Medicine and Howard Gilmanand Ron and Jean Schiavone Institutes, State University of New York Downstate College of Medicine, New York, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Dickstein, Kenneth" sort="Dickstein, Kenneth" uniqKey="Dickstein K" first="Kenneth" last="Dickstein">Kenneth Dickstein</name><affiliation><nlm:affiliation>University of Bergen, Stavanger University Hospital, Stavanger, Norway.</nlm:affiliation></affiliation></author><author><name sortKey="Gras, Daniel" sort="Gras, Daniel" uniqKey="Gras D" first="Daniel" last="Gras">Daniel Gras</name><affiliation><nlm:affiliation>Nouvelles Cliniques Nantaises, Nantes, France.</nlm:affiliation></affiliation></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name><affiliation><nlm:affiliation>Monash Centre of Cardiovascular Research and Education in Therapeutics, Melbourne, VIC, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Brugada, Josep" sort="Brugada, Josep" uniqKey="Brugada J" first="Josep" last="Brugada">Josep Brugada</name><affiliation><nlm:affiliation>Cardiology Department, Thorax Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Robertson, Michele" sort="Robertson, Michele" uniqKey="Robertson M" first="Michele" last="Robertson">Michele Robertson</name><affiliation><nlm:affiliation>Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Ford, Ian" sort="Ford, Ian" uniqKey="Ford I" first="Ian" last="Ford">Ian Ford</name><affiliation><nlm:affiliation>Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Holzmeister, Johannes" sort="Holzmeister, Johannes" uniqKey="Holzmeister J" first="Johannes" last="Holzmeister">Johannes Holzmeister</name><affiliation><nlm:affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Ruschitzka, Frank" sort="Ruschitzka, Frank" uniqKey="Ruschitzka F" first="Frank" last="Ruschitzka">Frank Ruschitzka</name><affiliation><nlm:affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland gorcsanj@upmc.edu.</nlm:affiliation></affiliation></author></analytic><series><title level="j">European heart journal</title><idno type="eISSN">1522-9645</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arrhythmias, Cardiac (mortality)</term><term>Arrhythmias, Cardiac (physiopathology)</term><term>Arrhythmias, Cardiac (therapy)</term><term>Cardiac Resynchronization Therapy (methods)</term><term>Echocardiography, Doppler, Color</term><term>Electrocardiography</term><term>Female</term><term>Follow-Up Studies</term><term>Heart Failure (mortality)</term><term>Heart Failure (physiopathology)</term><term>Heart Failure (therapy)</term><term>Hospitalization</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term><term>Ventricular Dysfunction, Left (mortality)</term><term>Ventricular Dysfunction, Left (physiopathology)</term><term>Ventricular Dysfunction, Left (therapy)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Cardiac Resynchronization Therapy</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Arrhythmias, Cardiac</term><term>Heart Failure</term><term>Ventricular Dysfunction, Left</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arrhythmias, Cardiac</term><term>Heart Failure</term><term>Ventricular Dysfunction, Left</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Arrhythmias, Cardiac</term><term>Heart Failure</term><term>Ventricular Dysfunction, Left</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Echocardiography, Doppler, Color</term><term>Electrocardiography</term><term>Female</term><term>Follow-Up Studies</term><term>Hospitalization</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">EchoCRT was a randomized trial of cardiac resynchronization therapy (CRT) in severely symptomatic heart failure (HF) patients with narrow QRS width <130 ms, ejection fraction ≤35%, and echocardiographic dyssynchrony. All received CRT implants which were then randomized to CRT-On or CRT-Off. While the trial showed no benefit of CRT to these patients, the aim of this subgroup analysis was to test the hypothesis that persistent or worsening dyssynchrony is associated with unfavourable clinical outcomes.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26321238</PMID><DateCreated><Year>2015</Year><Month>12</Month><Day>29</Day></DateCreated><DateCompleted><Year>2016</Year><Month>10</Month><Day>05</Day></DateCompleted><DateRevised><Year>2016</Year><Month>12</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1522-9645</ISSN><JournalIssue CitedMedium="Internet"><Volume>37</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Jan</Month><Day>01</Day></PubDate></JournalIssue><Title>European heart journal</Title><ISOAbbreviation>Eur. Heart J.</ISOAbbreviation></Journal><ArticleTitle>Association of persistent or worsened echocardiographic dyssynchrony with unfavourable clinical outcomes in heart failure patients with narrow QRS width: a subgroup analysis of the EchoCRT trial.</ArticleTitle><Pagination><MedlinePgn>49-59</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/eurheartj/ehv418</ELocationID><Abstract><AbstractText Label="AIMS" NlmCategory="OBJECTIVE">EchoCRT was a randomized trial of cardiac resynchronization therapy (CRT) in severely symptomatic heart failure (HF) patients with narrow QRS width <130 ms, ejection fraction ≤35%, and echocardiographic dyssynchrony. All received CRT implants which were then randomized to CRT-On or CRT-Off. While the trial showed no benefit of CRT to these patients, the aim of this subgroup analysis was to test the hypothesis that persistent or worsening dyssynchrony is associated with unfavourable clinical outcomes.</AbstractText><AbstractText Label="METHODS AND RESULTS" NlmCategory="RESULTS">We studied 614 EchoCRT patients with baseline and 6-month echocardiograms. Baseline dyssynchrony required for study inclusion was either tissue Doppler imaging longitudinal velocity delay ≥80 ms or speckle-tracking radial strain delay ≥130 ms. Persistent dyssynchrony at 6 months was observed similarly in both groups (77% in CRT-On; 76% in CRT-Off). Persistent dyssynchrony was associated with a significantly higher primary end point of death or HF hospitalization (HR = 1.54, 95% CI 1.03-2.30, P = 0.03), and in particular secondary endpoint of HF hospitalization (HR = 1.66, 95% CI 1.07-2.57, P = 0.02). HF hospitalizations were also associated with worsening longitudinal dyssynchrony (HR = 1.45, 95% CI 1.02-2.05, P = 0.037), and worsening radial dyssynchrony (HR = 1.81, 95% CI 1.16-2.81, P = 0.008). Associations of persistent or worsening dyssynchrony with outcomes were similar in CRT-Off and CRT-On groups.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Persistent or worsening echocardiographic dyssynchrony in HF patients with narrow QRS width was a marker for unfavourable clinical outcomes unaffected by CRT. In particular, echocardiographic dyssynchrony on follow-up was strongly associated with HF hospitalizations and appears to be a prognostic marker of disease severity.</AbstractText><CopyrightInformation>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gorcsan</LastName><ForeName>John</ForeName><Initials>J</Initials><Suffix>3rd</Suffix><AffiliationInfo><Affiliation>University of Pittsburgh, Scaife 564, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA gorcsanj@upmc.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sogaard</LastName><ForeName>Peter</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Aalborg University, Aalborg, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bax</LastName><ForeName>Jeroen J</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Leiden University Medical Center, Leiden, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Jagmeet P</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Massachusetts General Hospital, Harvard Medical School, Boston, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Abraham</LastName><ForeName>William T</ForeName><Initials>WT</Initials><AffiliationInfo><Affiliation>Division of Cardiovascular Medicine, Ohio State University Medical Center, Davis Heart and Lung Research Institute, Columbus, USA gorcsanj@upmc.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Borer</LastName><ForeName>Jeffrey S</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Division of Cardiovascular Medicine and Howard Gilmanand Ron and Jean Schiavone Institutes, State University of New York Downstate College of Medicine, New York, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dickstein</LastName><ForeName>Kenneth</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>University of Bergen, Stavanger University Hospital, Stavanger, Norway.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gras</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Nouvelles Cliniques Nantaises, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krum</LastName><ForeName>Henry</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Monash Centre of Cardiovascular Research and Education in Therapeutics, Melbourne, VIC, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brugada</LastName><ForeName>Josep</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Cardiology Department, Thorax Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Robertson</LastName><ForeName>Michele</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ford</LastName><ForeName>Ian</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Holzmeister</LastName><ForeName>Johannes</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruschitzka</LastName><ForeName>Frank</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland gorcsanj@upmc.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>08</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur Heart J</MedlineTA><NlmUniqueID>8006263</NlmUniqueID><ISSNLinking>0195-668X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Eur Heart J. 2016 Jan 1;37(1):60-2</RefSource><PMID Version="1">26324539</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D001145" MajorTopicYN="N">Arrhythmias, Cardiac</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058406" MajorTopicYN="N">Cardiac Resynchronization Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018618" MajorTopicYN="N">Echocardiography, Doppler, Color</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="N">Heart Failure</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053208" MajorTopicYN="N">Kaplan-Meier Estimate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018487" MajorTopicYN="N">Ventricular Dysfunction, Left</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Cardiac resynchronization therapy</Keyword><Keyword MajorTopicYN="N">Echocardiography</Keyword><Keyword MajorTopicYN="N">Heart failure</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>07</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>07</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>9</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>9</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26321238</ArticleId><ArticleId IdType="pii">ehv418</ArticleId><ArticleId IdType="doi">10.1093/eurheartj/ehv418</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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