Abstract
Background: In patients with symptomatic Heart Failure (HF) and wide QRS duration, cardiac resynchronization therapy (CRT) causes reduction of morbidity and mortality. However, it's unclear which patient features predict short‐term response to this device therapy.
Aim of the Work: The research aimed to study which cases characteristics could expect short-term clinical and echocardiographic response to CRT.
Subjects and methods: This prospective cohort study involved 40 patients indicated for CRT device. The study was conducted in the cardiology departments, faculty of medicine, Zagazig University, and Police hospital at the period from October 2018 to October 2020. Clinical, laboratory, electrocardiographic, and echocardiographic assessments were performed pre and six months after implantation.
Results: Forty patients undergoing CRT implantation were included among which, 30 (75%) patients were considered responders after six months. From the present study, the responders to CRT were more frequently to be females with younger age than non -responders. Non-ischemic HF, left bundle branch block (LBBB) morphology and New York Heart Association (NYHA) functional class III were significantly more frequent in responders. Furthermore, responders had significantly wider baseline QRS duration, smaller baseline LV diastolic and systolic dimension and volumes, greater ejection fraction, lower levels of brain natriuretic peptide (BNP), and more baseline intra-ventricular dyssynchrony.
Conclusion: We concluded that pre-implantation independent Predictors of good CRT response are LBBB morphology, septal to posterior wall mechanical delay, wide QRS duration, interventricular mechanical delay, NYHA functional class III, and lower levels of BNP. Large scale study is recommended for further verification of study results.