Left ventricular wall thickness assessed by cardiac computed tomography and cardiac resynchronization therapy outcomes - Université de Rennes Access content directly
Journal Articles EP-Europace Year : 2020

Left ventricular wall thickness assessed by cardiac computed tomography and cardiac resynchronization therapy outcomes

Abstract

AIMS:Up to 30% of selected heart failure patients do not benefit clinically from cardiac resynchronization therapy (CRT). Left ventricular (LV) wall thickness (WT) analysed using computed tomography (CT) has rarely been evaluated in response to CRT and mitral regurgitation (MR) improvement. We examined the association of LVWT and the ability to reverse LV remodelling and MR improvement after CRT.METHODS AND RESULTS:Fifty-four patients scheduled for CRT underwent pre-procedural CT. Reduced LVWT was defined as WT <6 mm and quantified as a percentage of total LV area. Endpoints were 6-month clinical and echocardiographic response to CRT [New York Heart Association (NYHA) class, LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV)], MR improvement and 2-year major adverse cardiac events (MACE). Patients were divided into three groups according to the percentage of LVWT <6 mm area: ≤20%, 20-50%, and ≥50%. At 6 months, 75%, 71%, and 42% of the patients experienced NYHA improvement in the ≤20%, 20-50%, and ≥50% group, respectively. Additionally, ≤20% group presented higher LVEF, LVEDV, and LVESV positive response rate (86%, 59%, and 83%, respectively). Both 20-50% and ≥50% groups exhibited a lower LVEF, LVEDV, and LVESV positive response rate (52% and 42%; 47% and 45%; and 53% and 45%, respectively). Additionally, ≥25% of LVWT <6 mm inclusive of at least one papillary muscle insertion was the only predictor of lack of MR improvement. Lastly, ≥50% group experienced significantly lower 2-year MACE survival free probability.CONCLUSION:WT evaluated using CT could help to stratify the response to CRT and predict MR improvement and outcomes.CLINICAL TRIAL REGISTRATION:NCT01097733.
Fichier principal
Vignette du fichier
Galand et al-2019-Left ventricular wall thickness assessed by cardiac.pdf (1.48 Mo) Télécharger le fichier
Origin : Files produced by the author(s)

Dates and versions

hal-02440642 , version 1 (17-02-2020)

Identifiers

Cite

Vincent Galand, Brian Ghoshhajra, Jackie Szymonifka, Saumya Das, Mary Orencole, et al.. Left ventricular wall thickness assessed by cardiac computed tomography and cardiac resynchronization therapy outcomes. EP-Europace, 2020, 22 (3), pp.401-411. ⟨10.1093/europace/euz322⟩. ⟨hal-02440642⟩
53 View
119 Download

Altmetric

Share

Gmail Facebook X LinkedIn More