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Baseline QRS duration associates with cardiac recovery in patients with continuous-flow left ventricular assist device implantation.
Baseline QRS duration associates with cardiac recovery in patients with continuous-flow left ventricular assist device implantation.
- Source :
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American heart journal plus : cardiology research and practice [Am Heart J Plus] 2022 Sep 17; Vol. 22, pp. 100211. Date of Electronic Publication: 2022 Sep 17 (Print Publication: 2022). - Publication Year :
- 2022
-
Abstract
- Objective: In chronic heart failure (HF) patients supported with continuous-flow left ventricular assist device (CF-LVAD), we aimed to assess the clinical association of pre-LVAD QRS duration (QRSd) with post-LVAD cardiac recovery, and its correlation with pre- to post-LVAD change in left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD).<br />Methods: Chronic HF patients ( n  = 402) undergoing CF-LVAD implantation were prospectively enrolled, at one of the centers comprising the U.T.A.H. (Utah Transplant Affiliated Hospitals) consortium. After excluding patients with acute HF etiologies, hypertrophic or infiltrative cardiomyopathy, and/or inadequate post-LVAD follow up (<3 months), 315 patients were included in the study. Cardiac recovery was defined as LVEF ≥ 40 % and LVEDD < 6 cm within 12 months post-LVAD implantation. Patients fulfilling this condition were termed as responders (R) and results were compared with non-responders (NR).<br />Results: Thirty-five patients (11 %) achieved 'R' criteria, and exhibited a 15 % shorter QRSd compared to 'NR' (123 ± 37 ms vs 145 ± 36 ms; p  < 0.001). A univariate analysis identified association of baseline QRSd with post-LVAD cardiac recovery (OR: 0.986, 95 % CI: 0.976-0.996, p < 0.001). In a multivariate logistic regression model, after adjusting for duration of HF (OR: 0.990, 95 % CI: 0.983-0.997, p  = 0.006) and gender (OR: 0.388, 95 % CI: 0.160-0.943, p  = 0.037), pre-LVAD QRSd exhibited a significant association with post-LVAD cardiac structural and functional improvement (OR: 0.987, 95 % CI: 0.977-0.998, p  = 0.027) and the predictive model showed a c-statistic of 0.73 with p  < 0.001. The correlations for baseline QRSd with pre- to post-LVAD change in LVEF and LVEDD were also investigated in 'R' and 'NR' groups.<br />Conclusion: Chronic advanced HF patients with a shorter baseline QRSd exhibit an increased potential for cardiac recovery after LVAD support.<br />Competing Interests: RR is a consultant for Abbott, Medtronic, and Biosense Webster. All other authors have no relevant financial or non-financial interests to disclose.<br /> (© 2022 Published by Elsevier Inc.)
Details
- Language :
- English
- ISSN :
- 2666-6022
- Volume :
- 22
- Database :
- MEDLINE
- Journal :
- American heart journal plus : cardiology research and practice
- Publication Type :
- Academic Journal
- Accession number :
- 38558900
- Full Text :
- https://doi.org/10.1016/j.ahjo.2022.100211