Relationship between Sex, Body Size, and Cardiac Resynchronization Therapy Benefit: A Patient Level Meta-Analysis of Randomized Controlled Trials.
QRS
cardiac resynchronization therapy
heart failure
meta-analysis
sex
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
13 Feb 2024
13 Feb 2024
Historique:
received:
07
10
2023
revised:
24
01
2024
accepted:
26
01
2024
medline:
16
2
2024
pubmed:
16
2
2024
entrez:
15
2
2024
Statut:
aheadofprint
Résumé
Women might benefit more from cardiac resynchronization therapy(CRT) than men, and do so at shorter QRS durations(QRSd). To determine if sex-based differences in CRT effects are better accounted for by height, body surface area (BSA), or left ventricular end-diastolic dimension(LVEDD). We analyzed patient-level data from CRT trials (MIRACLE, MIRACLE-ICD, MIRACLE-ICD II, REVERSE, RAFT, COMPANION, and MADIT-CRT) using Bayesian Hierarchical Weibull regression models. Relationships between QRSd and CRT effects were examined overall and in sex-stratified cohorts; additional analyses indexed QRSd by height, BSA, or LVEDD. Endpoints were heart failure hospitalization (HFH) or death and all-cause mortality. Compared with men (n=5,628), women (n=1,439) were shorter (1.62[IQR 1.57-1.65]m versus 1.75[IQR 1.70-1.80]m; p<0.001) with smaller BSAs (1.76[IQR 1.62-1.90]m Although body size partially explains sex-specific QRSd thresholds for CRT benefit, it is not associated with the magnitude of CRT benefit. Indexing QRSd for body size might improve patient selection for CRT, particularly with a "borderline" QRSd.
Sections du résumé
BACKGROUND
BACKGROUND
Women might benefit more from cardiac resynchronization therapy(CRT) than men, and do so at shorter QRS durations(QRSd).
OBJECTIVE
OBJECTIVE
To determine if sex-based differences in CRT effects are better accounted for by height, body surface area (BSA), or left ventricular end-diastolic dimension(LVEDD).
METHODS
METHODS
We analyzed patient-level data from CRT trials (MIRACLE, MIRACLE-ICD, MIRACLE-ICD II, REVERSE, RAFT, COMPANION, and MADIT-CRT) using Bayesian Hierarchical Weibull regression models. Relationships between QRSd and CRT effects were examined overall and in sex-stratified cohorts; additional analyses indexed QRSd by height, BSA, or LVEDD. Endpoints were heart failure hospitalization (HFH) or death and all-cause mortality.
RESULTS
RESULTS
Compared with men (n=5,628), women (n=1,439) were shorter (1.62[IQR 1.57-1.65]m versus 1.75[IQR 1.70-1.80]m; p<0.001) with smaller BSAs (1.76[IQR 1.62-1.90]m
CONCLUSION
CONCLUSIONS
Although body size partially explains sex-specific QRSd thresholds for CRT benefit, it is not associated with the magnitude of CRT benefit. Indexing QRSd for body size might improve patient selection for CRT, particularly with a "borderline" QRSd.
Identifiants
pubmed: 38360252
pii: S1547-5271(24)00128-0
doi: 10.1016/j.hrthm.2024.01.058
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.