Background: Myocardial constructive work (CW) assessed by pressure strain loops (PSLs) is an independent predictor of cardiac resynchronization therapy response (CRT+).
Purpose of the study: To assess the role of CW in the prediction of long-term outcome in patients undergoing CRT.
Methods: 2D- and speckle-tracking echocardiography were performed in 166 CRT candidates (mean age: 66±10 years, males: 69%) before CRT implantation and at 6-month follow-up. Left-ventricular (LV) end-systolic volume reduction >15% at 6-month follow-up defined CRT+ and occurred in 48 (29%) patients.
Results: After a median 4-year FU (range: 1.3–5 years), all-cause death occurred in 28 patients (17%), cardiac death in 14 (8%). At Cox-regression analysis, CW emerged as an independent predictor of outcome (Table 1). A CW cut-off of 888 mmHg% (AUC 0.71, p=0.007 and AUC 0.67, p=0.004 for cardiac and all-cause mortality) was associated with an increased mortality risk (Figures 1, 2).
Conclusions: The estimation of LV-CW is a relatively novel tool, which allows the prediction of long-term outcome in CRT candidates.