Discrepancy between echocardiographic and patient-reported health status response to cardiac resynchronization therapy

Results of the PSYHEART-CRT study

H. Versteeg, J. van 't Sant, M.J. Cramer, P.A.F.M. Doevendans, S.S. Pedersen, M.M. Meine

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aims
The current study examined the degree of agreement between echocardiographic and patient-reported health status response to CRT 6 months after implantation, and evaluated the differences in pre-implantation characteristics of patients with concordant and discordant echocardiographic and health status responses.
Methods and results
Consecutively implanted CRT-defibrillator patients (n = 109, mean age = 65.4 ± 10.1 years, 74 men) were recruited from the University Medical Center Utrecht, The Netherlands. Prior to implantation and 6 months post-implantation, all patients underwent echocardiography and completed the Kansas City Cardiomyopathy Questionnaire (KCCQ). Echocardiographic response was defined as a relative reduction of ≥15% in LV end-systolic volume; an improvement of ≥10 points in KCCQ score indicated a health status response. In the 54 patients with discordant responses, 25 (22.9%) had an echocardiographic response but no health status response and 29 (26.6%) had a health status response but no echocardiographic response. Patients with concordant and discordant responses differed on various pre-implantation characteristics, including sex, employment status, LV volumes, and pre-implantation KCCQ score. In multivariable analysis, pre-implantation KCCQ score [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.88–0.95, P < 0.001] and QRS duration (OR = 1.03, 95% CI = 1.01–1.06, P = 0.009) were the only characteristics associated with health status response to CRT.
Conclusions
Our results show a large discrepancy between echocardiographic and patient-reported health status response to CRT. The most important predictor of health status response was the pre-implantation health status score. These results emphasize that disease-specific health status measures may have additional value over ‘objective’ measures of CRT response and should be incorporated in clinical practice.
Original languageEnglish
Pages (from-to)227-234
JournalEuropean Journal of Heart Failure
Volume16
DOIs
Publication statusPublished - 2014

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Odds Ratio
Confidence Intervals
Netherlands
Echocardiography
Surveys and Questionnaires

Cite this

Versteeg, H. ; van 't Sant, J. ; Cramer, M.J. ; Doevendans, P.A.F.M. ; Pedersen, S.S. ; Meine, M.M. / Discrepancy between echocardiographic and patient-reported health status response to cardiac resynchronization therapy : Results of the PSYHEART-CRT study. In: European Journal of Heart Failure. 2014 ; Vol. 16. pp. 227-234.
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title = "Discrepancy between echocardiographic and patient-reported health status response to cardiac resynchronization therapy: Results of the PSYHEART-CRT study",
abstract = "AimsThe current study examined the degree of agreement between echocardiographic and patient-reported health status response to CRT 6 months after implantation, and evaluated the differences in pre-implantation characteristics of patients with concordant and discordant echocardiographic and health status responses.Methods and resultsConsecutively implanted CRT-defibrillator patients (n = 109, mean age = 65.4 ± 10.1 years, 74 men) were recruited from the University Medical Center Utrecht, The Netherlands. Prior to implantation and 6 months post-implantation, all patients underwent echocardiography and completed the Kansas City Cardiomyopathy Questionnaire (KCCQ). Echocardiographic response was defined as a relative reduction of ≥15{\%} in LV end-systolic volume; an improvement of ≥10 points in KCCQ score indicated a health status response. In the 54 patients with discordant responses, 25 (22.9{\%}) had an echocardiographic response but no health status response and 29 (26.6{\%}) had a health status response but no echocardiographic response. Patients with concordant and discordant responses differed on various pre-implantation characteristics, including sex, employment status, LV volumes, and pre-implantation KCCQ score. In multivariable analysis, pre-implantation KCCQ score [odds ratio (OR) = 0.91, 95{\%} confidence interval (CI) = 0.88–0.95, P < 0.001] and QRS duration (OR = 1.03, 95{\%} CI = 1.01–1.06, P = 0.009) were the only characteristics associated with health status response to CRT.ConclusionsOur results show a large discrepancy between echocardiographic and patient-reported health status response to CRT. The most important predictor of health status response was the pre-implantation health status score. These results emphasize that disease-specific health status measures may have additional value over ‘objective’ measures of CRT response and should be incorporated in clinical practice.",
author = "H. Versteeg and {van 't Sant}, J. and M.J. Cramer and P.A.F.M. Doevendans and S.S. Pedersen and M.M. Meine",
year = "2014",
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language = "English",
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pages = "227--234",
journal = "European Journal of Heart Failure",
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Discrepancy between echocardiographic and patient-reported health status response to cardiac resynchronization therapy : Results of the PSYHEART-CRT study. / Versteeg, H.; van 't Sant, J.; Cramer, M.J.; Doevendans, P.A.F.M.; Pedersen, S.S.; Meine, M.M.

In: European Journal of Heart Failure, Vol. 16, 2014, p. 227-234.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Discrepancy between echocardiographic and patient-reported health status response to cardiac resynchronization therapy

T2 - Results of the PSYHEART-CRT study

AU - Versteeg, H.

AU - van 't Sant, J.

AU - Cramer, M.J.

AU - Doevendans, P.A.F.M.

AU - Pedersen, S.S.

AU - Meine, M.M.

PY - 2014

Y1 - 2014

N2 - AimsThe current study examined the degree of agreement between echocardiographic and patient-reported health status response to CRT 6 months after implantation, and evaluated the differences in pre-implantation characteristics of patients with concordant and discordant echocardiographic and health status responses.Methods and resultsConsecutively implanted CRT-defibrillator patients (n = 109, mean age = 65.4 ± 10.1 years, 74 men) were recruited from the University Medical Center Utrecht, The Netherlands. Prior to implantation and 6 months post-implantation, all patients underwent echocardiography and completed the Kansas City Cardiomyopathy Questionnaire (KCCQ). Echocardiographic response was defined as a relative reduction of ≥15% in LV end-systolic volume; an improvement of ≥10 points in KCCQ score indicated a health status response. In the 54 patients with discordant responses, 25 (22.9%) had an echocardiographic response but no health status response and 29 (26.6%) had a health status response but no echocardiographic response. Patients with concordant and discordant responses differed on various pre-implantation characteristics, including sex, employment status, LV volumes, and pre-implantation KCCQ score. In multivariable analysis, pre-implantation KCCQ score [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.88–0.95, P < 0.001] and QRS duration (OR = 1.03, 95% CI = 1.01–1.06, P = 0.009) were the only characteristics associated with health status response to CRT.ConclusionsOur results show a large discrepancy between echocardiographic and patient-reported health status response to CRT. The most important predictor of health status response was the pre-implantation health status score. These results emphasize that disease-specific health status measures may have additional value over ‘objective’ measures of CRT response and should be incorporated in clinical practice.

AB - AimsThe current study examined the degree of agreement between echocardiographic and patient-reported health status response to CRT 6 months after implantation, and evaluated the differences in pre-implantation characteristics of patients with concordant and discordant echocardiographic and health status responses.Methods and resultsConsecutively implanted CRT-defibrillator patients (n = 109, mean age = 65.4 ± 10.1 years, 74 men) were recruited from the University Medical Center Utrecht, The Netherlands. Prior to implantation and 6 months post-implantation, all patients underwent echocardiography and completed the Kansas City Cardiomyopathy Questionnaire (KCCQ). Echocardiographic response was defined as a relative reduction of ≥15% in LV end-systolic volume; an improvement of ≥10 points in KCCQ score indicated a health status response. In the 54 patients with discordant responses, 25 (22.9%) had an echocardiographic response but no health status response and 29 (26.6%) had a health status response but no echocardiographic response. Patients with concordant and discordant responses differed on various pre-implantation characteristics, including sex, employment status, LV volumes, and pre-implantation KCCQ score. In multivariable analysis, pre-implantation KCCQ score [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.88–0.95, P < 0.001] and QRS duration (OR = 1.03, 95% CI = 1.01–1.06, P = 0.009) were the only characteristics associated with health status response to CRT.ConclusionsOur results show a large discrepancy between echocardiographic and patient-reported health status response to CRT. The most important predictor of health status response was the pre-implantation health status score. These results emphasize that disease-specific health status measures may have additional value over ‘objective’ measures of CRT response and should be incorporated in clinical practice.

U2 - 10.1002/ejhf.38

DO - 10.1002/ejhf.38

M3 - Article

VL - 16

SP - 227

EP - 234

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

ER -