A Novel and Simple Exercise Test Parameter to Assess Responsiveness to Cardiac Resynchronization Therapy
This study assessed the value of heart rate recovery index (HRRI), a new parameter of an exercise test, as the predictor of response to cardiac resynchronization therapy (CRT). Methods: Consecutive patients receiving a CRT device were followed up after implantation and every 6 months. An effort test...
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Published in | Diagnostics (Basel) Vol. 10; no. 11; p. 920 |
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Abstract | This study assessed the value of heart rate recovery index (HRRI), a new parameter of an exercise test, as the predictor of response to cardiac resynchronization therapy (CRT). Methods: Consecutive patients receiving a CRT device were followed up after implantation and every 6 months. An effort test (ET) was quantified by minimum heart rate/maximum heart rate, as well as acceleration and deceleration times. HRRI was calculated as the ratio between acceleration and deceleration time (AT/DT) and compared to outcome. We used logistic regression to assess the predictive value of HRRI for responders and non-responders to CRT. The area under the curve (AUC) was computed to distinguish between positive and negative outcomes. Results: A total of 109 patients (74 men, mean age 63.3 ± 9.8 years) were analyzed; permanent long-term fusion CRT pacing was possible in 65 patients. Patients were assigned to two groups: responders and non-responders (98/11 patients). During a mean follow-up of 36 months, 545 ETs were performed. HRRI was significantly higher in responders versus non-responders (3.16 ± 2 vs. 1.4 ± 0.5, p < 0.001). The optimal cutoff value for HRRI as a predictor of CRT response was 1.51 (area under the receiver operating characteristic (ROC) curve = 0.844). Responders had significant left-ventricular (LV) reverse remodeling (LV end-diastolic volume = 240 ± 90 mL vs. 217 ± 89 mL, p < 0.001) and higher LV ejection fraction (26 ± 5.8% vs. 35 ± 8.7%, p < 0.001). Conclusions: HRRI computation during routine ET is useful for the evaluation of responsiveness to CRT. |
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AbstractList | This study assessed the value of heart rate recovery index (HRRI), a new parameter of an exercise test, as the predictor of response to cardiac resynchronization therapy (CRT). Methods: Consecutive patients receiving a CRT device were followed up after implantation and every 6 months. An effort test (ET) was quantified by minimum heart rate/maximum heart rate, as well as acceleration and deceleration times. HRRI was calculated as the ratio between acceleration and deceleration time (AT/DT) and compared to outcome. We used logistic regression to assess the predictive value of HRRI for responders and non-responders to CRT. The area under the curve (AUC) was computed to distinguish between positive and negative outcomes. Results: A total of 109 patients (74 men, mean age 63.3 ± 9.8 years) were analyzed; permanent long-term fusion CRT pacing was possible in 65 patients. Patients were assigned to two groups: responders and non-responders (98/11 patients). During a mean follow-up of 36 months, 545 ETs were performed. HRRI was significantly higher in responders versus non-responders (3.16 ± 2 vs. 1.4 ± 0.5, p < 0.001). The optimal cutoff value for HRRI as a predictor of CRT response was 1.51 (area under the receiver operating characteristic (ROC) curve = 0.844). Responders had significant left-ventricular (LV) reverse remodeling (LV end-diastolic volume = 240 ± 90 mL vs. 217 ± 89 mL, p < 0.001) and higher LV ejection fraction (26 ± 5.8% vs. 35 ± 8.7%, p < 0.001). Conclusions: HRRI computation during routine ET is useful for the evaluation of responsiveness to CRT. This study assessed the value of heart rate recovery index (HRRI), a new parameter of an exercise test, as the predictor of response to cardiac resynchronization therapy (CRT). Methods : Consecutive patients receiving a CRT device were followed up after implantation and every 6 months. An effort test (ET) was quantified by minimum heart rate/maximum heart rate, as well as acceleration and deceleration times. HRRI was calculated as the ratio between acceleration and deceleration time (AT/DT) and compared to outcome. We used logistic regression to assess the predictive value of HRRI for responders and non-responders to CRT. The area under the curve (AUC) was computed to distinguish between positive and negative outcomes. Results : A total of 109 patients (74 men, mean age 63.3 ± 9.8 years) were analyzed; permanent long-term fusion CRT pacing was possible in 65 patients. Patients were assigned to two groups: responders and non-responders (98/11 patients). During a mean follow-up of 36 months, 545 ETs were performed. HRRI was significantly higher in responders versus non-responders (3.16 ± 2 vs. 1.4 ± 0.5, p < 0.001). The optimal cutoff value for HRRI as a predictor of CRT response was 1.51 (area under the receiver operating characteristic (ROC) curve = 0.844). Responders had significant left-ventricular (LV) reverse remodeling (LV end-diastolic volume = 240 ± 90 mL vs. 217 ± 89 mL, p < 0.001) and higher LV ejection fraction (26 ± 5.8% vs. 35 ± 8.7%, p < 0.001). Conclusions : HRRI computation during routine ET is useful for the evaluation of responsiveness to CRT. |
Author | Vacarescu, Cristina Vatasescu, Radu Goanta, Emilia Violeta Gurgu, Andra Lazar, Mihai-Andrei Petrescu, Lucian Crisan, Simina Streian, Caius Glad Rachieru, Ciprian Luca, Constantin Tudor Cozma, Dragos Dragomir, Angela Chahine, Kandara Mohamed Cozlac, Alina-Ramona |
AuthorAffiliation | 3 Department 4, Cardio-Thoracic Pathology, “Carol Davila” University of Medicine and Pharmacy, Dionisie Lupu Street, no. 37, Sector 2, 020021 Bucharest, Romania; radu_vatasescu@yahoo.com 5 Internal Medicine Department, County Emergency Hospital, 5 Gheorghe Dima Street, 300079 Timisoara, Romania 1 Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; nicoramo_alina@yahoo.com (A.-R.C.); costiluca67@yahoo.com (C.T.L.); vacarescucristina@yahoo.com (C.V.); cstr100@gmail.com (C.G.S.); mihai88us@yahoo.com (M.-A.L.); gurgu_andra@yahoo.com (A.G.); ema.goanta@yahoo.com (E.V.G.); chahinek.med@hotmail.com (K.M.C.); ciprianrachieru@yahoo.com (C.R.); dragoscozma@gmail.com (D.C.) 2 Cardiology Department, Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; ange.dragomir@gmail.com 4 Cardiology Department, Clinical Emergency Hospital Bucharest, 8 Calea Floreasca, 014461 Bucharest, Romania |
AuthorAffiliation_xml | – name: 5 Internal Medicine Department, County Emergency Hospital, 5 Gheorghe Dima Street, 300079 Timisoara, Romania – name: 4 Cardiology Department, Clinical Emergency Hospital Bucharest, 8 Calea Floreasca, 014461 Bucharest, Romania – name: 2 Cardiology Department, Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; ange.dragomir@gmail.com – name: 1 Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; nicoramo_alina@yahoo.com (A.-R.C.); costiluca67@yahoo.com (C.T.L.); vacarescucristina@yahoo.com (C.V.); cstr100@gmail.com (C.G.S.); mihai88us@yahoo.com (M.-A.L.); gurgu_andra@yahoo.com (A.G.); ema.goanta@yahoo.com (E.V.G.); chahinek.med@hotmail.com (K.M.C.); ciprianrachieru@yahoo.com (C.R.); dragoscozma@gmail.com (D.C.) – name: 3 Department 4, Cardio-Thoracic Pathology, “Carol Davila” University of Medicine and Pharmacy, Dionisie Lupu Street, no. 37, Sector 2, 020021 Bucharest, Romania; radu_vatasescu@yahoo.com |
Author_xml | – sequence: 1 givenname: Alina-Ramona surname: Cozlac fullname: Cozlac, Alina-Ramona – sequence: 2 givenname: Lucian surname: Petrescu fullname: Petrescu, Lucian – sequence: 3 givenname: Simina surname: Crisan fullname: Crisan, Simina – sequence: 4 givenname: Constantin Tudor surname: Luca fullname: Luca, Constantin Tudor – sequence: 5 givenname: Cristina surname: Vacarescu fullname: Vacarescu, Cristina – sequence: 6 givenname: Caius Glad surname: Streian fullname: Streian, Caius Glad – sequence: 7 givenname: Mihai-Andrei surname: Lazar fullname: Lazar, Mihai-Andrei – sequence: 8 givenname: Andra surname: Gurgu fullname: Gurgu, Andra – sequence: 9 givenname: Angela surname: Dragomir fullname: Dragomir, Angela – sequence: 10 givenname: Emilia Violeta surname: Goanta fullname: Goanta, Emilia Violeta – sequence: 11 givenname: Radu orcidid: 0000-0001-7163-8528 surname: Vatasescu fullname: Vatasescu, Radu – sequence: 12 givenname: Kandara Mohamed surname: Chahine fullname: Chahine, Kandara Mohamed – sequence: 13 givenname: Ciprian surname: Rachieru fullname: Rachieru, Ciprian – sequence: 14 givenname: Dragos surname: Cozma fullname: Cozma, Dragos |
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Title | A Novel and Simple Exercise Test Parameter to Assess Responsiveness to Cardiac Resynchronization Therapy |
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