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Extent of Viability to Predict Response to Cardiac Resynchronization Therapy in Ischemic Heart Failure Patients

Claudia Ypenburg1, Martin J. Schalij1, Gabe B. Bleeker1,2, Paul Steendijk1, Eric Boersma3, Petra Dibbets-Schneider4, Marcel P. Stokkel4, Ernst E. van der Wall1 and Jeroen J. Bax1

1 Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; 2 Interuniversity Cardiology Institute Netherlands, Utrecht, The Netherlands; 3 Department of Epidemiology and Statistics, Erasmus University Rotterdam, Rotterdam, The Netherlands; and 4 Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands


Figure 1
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  		FIGURE 1.  (A) Relationship between extent of viability (number of viable segments) and absolute change in LVEF after 6 mo. (B) Relationship between total scar score and absolute change in LVEF after 6 mo.

 

Figure 2
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  		FIGURE 2.  Mean LVEF (A), LV end-diastolic volume (LVEDV) (B), and LV end-systolic volume (LVESV) (C) at baseline (open columns) and after 6 mo of CRT (solid columns). *P < 0.01 baseline vs. follow-up.

 

Figure 3
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  		FIGURE 3.  (A and B) ROC curve analysis on extent of viability before CRT implantation and response after 6 mo of CRT (A), with good predictive value (area under curve [AUC] = 0.88) to predict response (B). Small numbers (2–14) next to the line in B indicate extent of viability. (C and D) ROC curve analysis on total score before CRT implantation and response after 6 mo of CRT (C), also with good predictive value (AUC = 0.86) to predict nonresponse (D). Small numbers next to line indicate total scar score.

 




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