Yitschak Biton1, Ilan Goldenberg2, Valentina Kutyifa3, Jayson R Baman3, Scott Solomon4, Arthur J Moss3, Barbara Szepietowska3, Scott McNitt3, Bronislava Polonsky3, Wojciech Zareba3, Alon Barsheshet5. 1. Heart Research Follow-up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: yitschak.biton@heart.rochester.edu. 2. Heart Research Follow-up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Heart Research Follow-up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York. 4. Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 5. Heart Research Follow-up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Cardiology Department, Rabin Medical Center, Petah Tiqva, and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND:Relative wall thickness (RWT), defined as 2 times posterior wall thickness divided by the left ventricular (LV) diastolic diameter, is a measure of LV geometry and may be a marker for adverse events in patients with LV dysfunction. OBJECTIVES: The aim of this study was to investigate the relationship between RWT and the risk for ventricular tachyarrhythmia (VA) in patients enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. METHODS: The study population comprised 1,260 patients with mild heart failure and left bundle branch block. RESULTS: In a multivariable model, RWT was the most powerful echocardiographic measure for estimating the risk of VAs compared with commonly used echocardiographic variables. Patients with low RWT (<0.24) had 83% (p < 0.001) increased risk for VA and 68% (p < 0.001) increase in VA risk or death (VA/death) compared with patients with higher RWT values. Each 0.01-unit decrease in RWT was associated with 12% (p < 0.001) and 10% (p < 0.001) increases in the risk of VA and VA/death, respectively. Treatment with cardiac resynchronization therapy with defibrillator (CRT-D; CRT with implantable cardioverter-defibrillator) was associated with a greater increase in RWT compared with implantable cardioverter-defibrillator at 12 months (4.6 ± 6.8% vs. 1.5 ± 2.7%; p < 0.001), and every 10% increase in RWT in CRT-D patients was associated with 34% (p = 0.027) and 36% (p = 0.009) reductions in the risk of subsequent VA and VA/death, respectively. CONCLUSIONS: In patients with mild heart failure and left bundle branch block, decreased RWT was associated with an increase in the risk of VA and VA/death. CRT-D therapy was associated with a favorable increase in RWT and reduction in risk of VA and VA/death. (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy [MADIT-CRT]; NCT00180271).
RCT Entities:
BACKGROUND: Relative wall thickness (RWT), defined as 2 times posterior wall thickness divided by the left ventricular (LV) diastolic diameter, is a measure of LV geometry and may be a marker for adverse events in patients with LV dysfunction. OBJECTIVES: The aim of this study was to investigate the relationship between RWT and the risk for ventricular tachyarrhythmia (VA) in patients enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. METHODS: The study population comprised 1,260 patients with mild heart failure and left bundle branch block. RESULTS: In a multivariable model, RWT was the most powerful echocardiographic measure for estimating the risk of VAs compared with commonly used echocardiographic variables. Patients with low RWT (<0.24) had 83% (p < 0.001) increased risk for VA and 68% (p < 0.001) increase in VA risk or death (VA/death) compared with patients with higher RWT values. Each 0.01-unit decrease in RWT was associated with 12% (p < 0.001) and 10% (p < 0.001) increases in the risk of VA and VA/death, respectively. Treatment with cardiac resynchronization therapy with defibrillator (CRT-D; CRT with implantable cardioverter-defibrillator) was associated with a greater increase in RWT compared with implantable cardioverter-defibrillator at 12 months (4.6 ± 6.8% vs. 1.5 ± 2.7%; p < 0.001), and every 10% increase in RWT in CRT-D patients was associated with 34% (p = 0.027) and 36% (p = 0.009) reductions in the risk of subsequent VA and VA/death, respectively. CONCLUSIONS: In patients with mild heart failure and left bundle branch block, decreased RWT was associated with an increase in the risk of VA and VA/death. CRT-D therapy was associated with a favorable increase in RWT and reduction in risk of VA and VA/death. (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy [MADIT-CRT]; NCT00180271).
Authors: Swati Choudhry; Amber Salter; Tyler W Cunningham; Philip T Levy; Hoang H Nguyen; Michael Wallendorf; Gautam K Singh; Mark C Johnson Journal: J Am Soc Echocardiogr Date: 2017-06-07 Impact factor: 5.251
Authors: Eva Maria Javier Delmo; Mariano Francisco Del Maria Javier; Dietmar Böthig; Andre Rüffer; Robert Cesnjevar; Michael Dandel; Roland Hetzer Journal: Cardiovasc Diagn Ther Date: 2021-02
Authors: Camila M Urzua Fresno; Luciano Folador; Tamar Shalmon; Faisal Mhd Dib Hamad; Sheldon M Singh; Gauri R Karur; Nigel S Tan; Iqwal Mangat; Anish Kirpalani; Binita Riya Chacko; Laura Jimenez-Juan; Andrew T Yan; Djeven P Deva Journal: J Cardiovasc Magn Reson Date: 2021-06-10 Impact factor: 5.364