A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
Objectives. It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. Methods. We retrospectively reviewed 387 CRT patients. Multivariate logisti...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/3856294 |
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| author | Xi Liu Yiran Hu Wei Hua Shengwen Yang Min Gu Hong-Xia Niu Li-Gang Ding Jing Wang Shu Zhang |
| author_facet | Xi Liu Yiran Hu Wei Hua Shengwen Yang Min Gu Hong-Xia Niu Li-Gang Ding Jing Wang Shu Zhang |
| author_sort | Xi Liu |
| collection | DOAJ |
| description | Objectives. It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. Methods. We retrospectively reviewed 387 CRT patients. Multivariate logistic regression analysis was performed to identify predictors for super-response (defined as an absolute increase in left ventricular ejection fraction of ≥15% at 6-month follow-up) and to create a score model. Multivariate Cox proportional-hazard regression analysis was conducted to assess associations with the long-term endpoint (defined as cardiac death/heart transplant, heart failure (HF) hospitalization, or all-cause death) across the score categories at follow-up. Results. Among 387 patients, 109 (28.2%) met super-response. In multivariable analysis, 5 independent predictors (QQ-LAE) were identified: prior no fragmented QRS (odds ratio (OR) = 3.10 (1.39, 6.94)), QRS duration ≥170 ms (OR = 2.37 (1.35, 4.12)), left bundle branch block (OR = 2.57 (1.04, 6.37)), left atrial diameter <45 mm (OR = 3.27 (1.81, 5.89)), and left ventricular end-diastolic dimension <75 mm (OR = 4.11 (1.99, 8.48)). One point was attributed to each predictor, and three score categories were identified. The proportion of super-response after 6-month CRT implantation in patients with scores 0–3, 4, and 5 was 14.6%, 40.3%, and 64.1%, respectively (P<0.001). Patients with score 5 had an 88% reduction in the risk of cardiac death/heart transplant (P=0.042), a 71% reduction in the risk of HF hospitalization (P=0.048), and an 89% reduction in the risk of all-cause mortality (P=0.028) compared to patients with scores 0–3. Conclusions. The QQ-LAE score can be used for prediction of super-response to CRT and selection of most suitable patients in clinical practices. |
| format | Article |
| id | doaj-art-6d253b6191cd44d1bc7ec11a6c70edc0 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-6d253b6191cd44d1bc7ec11a6c70edc02025-02-03T01:04:47ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/38562943856294A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE ScoreXi Liu0Yiran Hu1Wei Hua2Shengwen Yang3Min Gu4Hong-Xia Niu5Li-Gang Ding6Jing Wang7Shu Zhang8State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaObjectives. It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. Methods. We retrospectively reviewed 387 CRT patients. Multivariate logistic regression analysis was performed to identify predictors for super-response (defined as an absolute increase in left ventricular ejection fraction of ≥15% at 6-month follow-up) and to create a score model. Multivariate Cox proportional-hazard regression analysis was conducted to assess associations with the long-term endpoint (defined as cardiac death/heart transplant, heart failure (HF) hospitalization, or all-cause death) across the score categories at follow-up. Results. Among 387 patients, 109 (28.2%) met super-response. In multivariable analysis, 5 independent predictors (QQ-LAE) were identified: prior no fragmented QRS (odds ratio (OR) = 3.10 (1.39, 6.94)), QRS duration ≥170 ms (OR = 2.37 (1.35, 4.12)), left bundle branch block (OR = 2.57 (1.04, 6.37)), left atrial diameter <45 mm (OR = 3.27 (1.81, 5.89)), and left ventricular end-diastolic dimension <75 mm (OR = 4.11 (1.99, 8.48)). One point was attributed to each predictor, and three score categories were identified. The proportion of super-response after 6-month CRT implantation in patients with scores 0–3, 4, and 5 was 14.6%, 40.3%, and 64.1%, respectively (P<0.001). Patients with score 5 had an 88% reduction in the risk of cardiac death/heart transplant (P=0.042), a 71% reduction in the risk of HF hospitalization (P=0.048), and an 89% reduction in the risk of all-cause mortality (P=0.028) compared to patients with scores 0–3. Conclusions. The QQ-LAE score can be used for prediction of super-response to CRT and selection of most suitable patients in clinical practices.http://dx.doi.org/10.1155/2020/3856294 |
| spellingShingle | Xi Liu Yiran Hu Wei Hua Shengwen Yang Min Gu Hong-Xia Niu Li-Gang Ding Jing Wang Shu Zhang A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score Cardiology Research and Practice |
| title | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
| title_full | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
| title_fullStr | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
| title_full_unstemmed | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
| title_short | A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score |
| title_sort | predictive model for super response to cardiac resynchronization therapy the qq lae score |
| url | http://dx.doi.org/10.1155/2020/3856294 |
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