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Abstract
Aims
Response to cardiac resynchronization therapy (CRT) is known to be associated with a number of clinical characteristics, including QRS duration and morphology, gender, height, and the aetiology of heart failure (HF). We assessed the relation of gender and baseline characteristics with QRS duration and Kansas City Cardiomyopathy Questionnaire.
Methods and results
AdaptResponse is a global randomized trial. The trial enrolled CRT‐indicated patients with New York Heart Association classes II–IV HF, left bundle branch block (QRS ≥ 140 ms in men, ≥130 ms in women), and baseline PR interval ≤200 ms. In total, 3620 patients were randomized, including 1569 women (43.3%) approaching the actual proportion of women in the HF population. Women were older and more often New York Heart Association class III or IV than men (55.6% vs. 48.7%), had less frequent ischaemic cardiomyopathy (21.2% vs. 39.5%), and had a 5.1 ms shorter QRS duration than men. Women were more often depressed (18.5% vs. 9.7%), had a significantly lower Kansas City Cardiomyopathy Questionnaire score, and had differences in medication prescriptions.
Conclusions
AdaptResponse is the largest randomized CRT trial and enrolled more women than any other landmark CRT trial. Women differed from men with regard to baseline characteristics and quality of life. Whether these differences translate into clinical outcome differences will be examined further in the AdaptResponse trial.
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Details
1 Cleveland Clinic, Cleveland, OH, USA
2 University of Ottawa Heart Institute, Ottawa, Ontario, Canada
3 Department of Cardiology, Medical University of South Carolina, Charleston, SC, USA
4 Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
5 Medtronic Bakken Research Center, Maastricht, The Netherlands
6 National Cerebral and Cardiovascular Center, Osaka, Japan
7 Department of Cardiology, University of Rennes, Rennes, France
8 Department of Cardiology, Ziekenhuis Oost‐Limburg, Genk, Belgium and Hasselt University, Hasselt, Belgium
9 School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; School of Medicine, University of Cyprus, Nicosia, Cyprus