Cardiac Resynchronization Therapy, Chronic Heart Failure
Conditions
Brief summary
Cardiac resynchronization therapy (CRT) is a well-established treatment for patients with severe systolic heart failure (HF) and ventricular desynchronization. Despite the consistently observed structural and functional improvements as well as reductions in HF events and mortality in large multicenter randomized trials, 30% patients remain classified as nonresponders. Present evidences showed that QRS duration was the most effective parameter to predict responsivity of CRT in patients with severe HF. But some studies showed that QRS duration could be influenced by obesity and gender. Accordingly, the simple QRS interval width of body surface electrocardiograph should not be the most satisfactory parameter for screening patients suitable for CRT. Recent study showed that left ventricular electrical delay, as measured by the time from the onset of QRS to the LV electrogram peak (QLV), predicted CRT response. At long QLV intervals, atrioventricular optimization (AVO) can increase the likelihood of structural response to CRT. However, it is unclear whether it is suitable for Chinese patients. The investigators would like to validate this relation in a Chinese population and explore if a corrected QLV might do better to predict the responsivity of CRT.
Interventions
None listed
Sponsors
Southern Medical University, China
Fudan University
Beijing Chao Yang Hospital
The First Affiliated Hospital with Nanjing Medical University
First Affiliated Hospital, Sun Yat-Sen University
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* •More than 18 Years * Informed consent signed * NYHA class ≥ II, an ejection fraction of ≤ 0.35, QRS duration of ≥ 150 milliseconds with Non-LBBB) or ≥ 120 milliseconds with LBBB, who treated with CRT * The Estimated survival time was more than one year * sinus rhythm, pacemaker independent
Exclusion criteria
* •NYHA class I symptoms * Severe liver or kidney dysfunction * Valvular heart disease * Pregnancy or lactation women * percutaneous coronary intervention (PCI) or cardiac artery bypass graft (CABG) within 3 month * Have malignant tumors and the Estimated survival time was less than one year * an enzyme-positive myocardial infarction within 3 months before enrollment, or atrial fibrillation * any reasons cannot complete follow-up; Or researchers think that don't suit to be included in the research of other conditions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Left Ventricular End Systolic Volume (LVESV) | baseline and 6 months | change in LVESV |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| New York Heart Association (NYHA) | baseline and 6 months | change in NYHA |
| left ventricular ejection fraction (LVEF) | baseline and 6 months | change in LVEF |
Countries
China
Contacts
Primary ContactJuan Lei, M.D., Ph.D.
Outcome results
None listed