Display options
Cite
Maass AH, Vernooy K, Wijers SC, et al. Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study. Europace. 2018;20(2):e1-e10doi: 10.1093/europace/euw445.
Maass, A. H., Vernooy, K., Wijers, S. C., van 't Sant, J., Cramer, M. J., Meine, M., Allaart, C. P., De Lange, F. J., Prinzen, F. W., Gerritse, B., Erdtsieck, E., Scheerder, C. O. S., Hill, M. R. S., Scholten, M., Kloosterman, M., Ter Horst, I. A. H., Voors, A. A., Vos, M. A., Rienstra, M., & Van Gelder, I. C. (2018). Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 20(2), e1-e10. https://doi.org/10.1093/europace/euw445
Maass, Alexander H, et al. "Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study." Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology vol. 20,2 (2018): e1-e10. doi: https://doi.org/10.1093/europace/euw445
Maass AH, Vernooy K, Wijers SC, van 't Sant J, Cramer MJ, Meine M, Allaart CP, De Lange FJ, Prinzen FW, Gerritse B, Erdtsieck E, Scheerder COS, Hill MRS, Scholten M, Kloosterman M, Ter Horst IAH, Voors AA, Vos MA, Rienstra M, Van Gelder IC. Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study. Europace. 2018 Feb 01;20(2):e1-e10. doi: 10.1093/europace/euw445. PMID: 28339818.
Copy Download .nbib Format: NLM
Share it on

Europace. 2018 Feb 01;20(2):e1-e10. doi: 10.1093/europace/euw445.

Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

Alexander H Maass, Kevin Vernooy, Sofieke C Wijers, Jetske van 't Sant, Maarten J Cramer, Mathias Meine, Cornelis P Allaart, Frederik J De Lange, Frits W Prinzen, Bart Gerritse, Erna Erdtsieck, Coert O S Scheerder, Michael R S Hill, Marcoen Scholten, Mariëlle Kloosterman, Iris A H Ter Horst, Adriaan A Voors, Marc A Vos, Michiel Rienstra, Isabelle C Van Gelder

Affiliations

  1. Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands.
  2. Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.
  3. Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  4. Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
  5. Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
  6. Department of Physiology, University of Maastricht, Maastricht, The Netherlands.
  7. Medtronic Bakken Research Center, Maastricht, The Netherlands.
  8. Center for Translational Molecular Medicine, Utrecht, The Netherlands.
  9. Currently Employed by Medtronic Trading NL, Eindhoven, The Netherlands.
  10. Medtronic Inc, Minneapolis, MN, USA.
  11. Thoraxcenter Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
  12. Department of Medical Physiology, University of Utrecht, Hanzeplein 1, 9700RB Groningen, Utrecht, The Netherlands.

PMID: 28339818 DOI: 10.1093/europace/euw445

Abstract

AIMS: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in systolic heart failure patients with ventricular conduction delay. Variability of individual response to CRT warrants improved patient selection. The Markers and Response to CRT (MARC) study was designed to investigate markers related to response to CRT.

METHODS AND RESULTS: We prospectively studied the ability of 11 clinical, 11 electrocardiographic, 4 echocardiographic, and 16 blood biomarkers to predict CRT response in 240 patients. Response was measured by the reduction of indexed left ventricular end-systolic volume (LVESVi) at 6 months follow-up. Biomarkers were related to LVESVi change using log-linear regression on continuous scale. Covariates that were significant univariately were included in a multivariable model. The final model was utilized to compose a response score. Age was 67 ± 10 years, 63% were male, 46% had ischaemic aetiology, LV ejection fraction was 26 ± 8%, LVESVi was 75 ± 31 mL/m2, and QRS was 178 ± 23 ms. At 6 months LVESVi was reduced to 58 ± 31 mL/m2 (relative reduction of 22 ± 24%), 130 patients (61%) showed ≥ 15% LVESVi reduction. In univariate analysis 17 parameters were significantly associated with LVESVi change. In the final model age, QRSAREA (using vectorcardiography) and two echocardiographic markers (interventricular mechanical delay and apical rocking) remained significantly associated with the amount of reverse ventricular remodelling. This CAVIAR (CRT-Age-Vectorcardiographic QRSAREA -Interventricular Mechanical delay-Apical Rocking) response score also predicted clinical outcome assessed by heart failure hospitalizations and all-cause mortality.

CONCLUSIONS: The CAVIAR response score predicts the amount of reverse remodelling after CRT and may be used to improve patient selection. Clinical Trials: NCT01519908.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: [email protected].

Keywords: Biomarkers ; Cardiac resynchronization therapy ; Echocardiography; Electrocardiography ; Heart failure ; Vectorcardiography

Publication Types