Effect of QRS narrowing after cardiac resynchronization therapy on functional mitral regurgitation in patients with systolic heart failure

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dc.authorid0000-0002-4281-0867
dc.authorid0000-0003-2995-8792
dc.authorid0000-0003-0230-6575
dc.authorid0000-0003-2714-4584
dc.authorid0000-0001-5825-8627
dc.authorid0000-0002-4951-6716
dc.contributor.authorKaraca, O?uz
dc.contributor.authorOmaygenç, Mehmet Onur
dc.contributor.authorÇakal, Beytullah
dc.contributor.authorÇakal, Sinem Deniz
dc.contributor.authorGüneş, Hacı Murat
dc.contributor.authorBarutçu, İrfan
dc.contributor.authorBoztosun, Bilal
dc.contributor.authorKılıçaslan, Fethi
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:35:23Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:35:23Z
dc.date.issued2016
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractThe determinants of improvement in functional mitral regurgitation (FMR) after cardiac resynchronization therapy (CRT) remain unclear. We evaluated the predictors of FMR improvement and hypothesized that CRT-induced change in QRS duration (?QRS) might have an impact on FMR response after CRT. One hundred ten CRT recipients were enrolled. CRT response (?15 reduction in left ventricular end-systolic volume) and FMR response (absolute reduction in FMR volume) were assessed with echocardiography before and 6 months after CRT. The study end points included all-cause death or hospitalization assessed in 12 ± 3 months (range 1 to 18). A total of 71 patients (65%) responded to CRT at 6 months. FMR response was observed in 49 (69%) of the CRT responders and 8 (20%) of the CRT nonresponders (p <0.001). Although the baseline QRS durations were similar, the paced QRS durations were shorter (p = 0.012) and the ?QRS values were greater (p = 0.003) in FMR responders compared with FMR nonresponders. There was a linear correlation between ?QRS and change in regurgitant volume (r = 0.49, p <0.001). At multivariate analysis, baseline tenting area (p = 0.012) and ?QRS (p = 0.028) independently predicted FMR response. A ?QRS ? 20 ms was related to CRT response, FMR improvement, and lower rates of death or hospitalization during follow-up (p values <0.05). In conclusion, QRS narrowing after CRT independently predicts FMR response. A ?QRS ?20 ms after CRT is associated with a favorable outcome in all clinical end points.
dc.identifier.citationKaraca, O., Omaygenç, M., Çakal, B., Çakal, S., Barutçu, İ., Boztosun, B. ... Kılıçaslan, F. (2016). Effect of QRS narrowing after cardiac resynchronization therapy on functional mitral regurgitation. American Journal of Cardiology, 117(3), 412-419. https://dx.doi.org/10.1016/j.amjcard.2015.11.010
dc.identifier.doi10.1016/j.amjcard.2015.11.010
dc.identifier.endpage419
dc.identifier.issn0002-9149
dc.identifier.issue3
dc.identifier.scopusqualityQ1
dc.identifier.startpage412
dc.identifier.urihttps://hdl.handle.net/20.500.12511/749
dc.identifier.urihttps://dx.doi.org/10.1016/j.amjcard.2015.11.010
dc.identifier.volume117
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Inc.
dc.relation.ispartofAmerican Journal of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectMitral Valve Insufficiency
dc.subjectMitral Valve
dc.subjectIschemic Mitral
dc.titleEffect of QRS narrowing after cardiac resynchronization therapy on functional mitral regurgitation in patients with systolic heart failure
dc.typeArticle

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