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Do Baseline Diastolic Echocardiographic Parameters Predict Outcome after Resynchronization Therapy? Results from the PROSPECT Trial


  • Conflicts of Interest: Renee M. Sullivan, M.D., Jaime Murillo, M.D., Jing Ping Sun, M.D.: none. Bart Gerritse, Ph.D.: full-time employee and shareholder of Medtronic. Eugene Chung, M.D.: consultant for and research support from Medtronic, Boston Scientific, and Cardiomems. Michael V. Orlov, M.D., Ph.D.: consultant and/or funding for research from St. Jude Medical, Biotronik, Philips, Boston Scientific, and Bard Electrophysiology. Berthold Stegemann, Ph.D.: principal scientist at Bakken Research Center Medtronic Inc. Michelle Fedewa, Ph.D.: prior full-time employee of Medtronic. Brett J. Peterson, B.S.: full-time employee of Medtronic. Brian Olshansky, M.D.: honoraria, funding for research, and/or consultant with Medtronic, Boston Scientific, Astellas, Novartis, and BioControl.

Address for reprints: Brian Olshansky M.D., 4426a JCP, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242. Fax: 319-384-6247; e-mail:



Cardiac resynchronization therapy (CRT) can improve clinical and cardiac structural status in heart failure patients. The role of baseline diastolic echocardiographic parameters to characterize the likelihood of positive outcomes is not well known. We explored relationships between diastolic parameters and outcomes 6 months after CRT implant in the Predictors of Response to CRT (PROSPECT) Trial.


We hypothesized that diastolic echocardiographic parameters were associated with clinical and structural outcomes in CRT patients.


For 426 patients in PROSPECT, a prospective observational trial of CRT, baseline E/A ratio, left atrial (LA) area, isovolumic relaxation time, left ventricular inflow deceleration time, E′ velocity, and E/E′ ratio were evaluated and related to 6-month clinical composite score (CCS) and left ventricular end-systolic volume (LVESV) reduction using Spearman rank-order correlations. Parameters associated with outcomes were analyzed further by discrete categorization.


As continuous variables, only E/A ratio and LA area correlated with CCSs (P = 0.017, P = 0.045, respectively) and relative change in LVESV at 6 months (P < 0.0001, P = 0.001, respectively). As discrete variables, E/A ratio and LA area also correlated with CCSs and LVESV.


Diastolic echo parameters E/A ratio and LA area were associated with clinical and structural outcomes in CRT patients at 6 months.

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