Predictors of response to CRT from the MADIT-CRT

Predictors of response to CRT from the MADIT-CRT

Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) trial evaluated the use of cardiac resynchronization-defibrillator therapy (CRT-D) in about thousand eight hundred patients. Percent reduction in left ventricular end-diastolic volume one year after CRT-D implantation was taken as the parameter to document echocardiographic response to CRT-D, indicating left ventricular reverse remodeling which is considered beneficial. Ilan Goldenberg, Arthur J Moss, W Jackson Hall, Elyse Foster, Jeffrey J Goldberger, Peter Santucci, Timothy Shinn, Scott Solomon, Jonathan S Steinberg, David Wilber, Alon Barsheshet, Scott McNitt, Wojciech Zareba and Helmut Klein, the MADIT-CRT Executive Committee [1] found that the predictors of response to CRT were: female sex, nonischemic origin, left bundle-branch block, QRS duration of 150 milliseconds or more, prior hospitalization for heart failure, left ventricular end-diastolic volume of 125 mL/m2 or more, and left atrial volume of less than 40 mL/m2. Thirteen percent increase in the clinical benefit of CRT-D was noted for every point increment in the response score (scores ranged from zero to fourteen) by multivariate analysis. The response score was created by a best subset regression analysis.

Reference

  1. Ilan Goldenberg, Arthur J Moss, W Jackson Hall, Elyse Foster, Jeffrey J Goldberger, Peter Santucci, Timothy Shinn, Scott Solomon, Jonathan S Steinberg, David Wilber, Alon Barsheshet, Scott McNitt, Wojciech Zareba, Helmut Klein, MADIT-CRT Executive Committee. Predictors of Response to Cardiac Resynchronization Therapy in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT). Circulation. 2011 Oct 4;124(14):1527-36.