Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Standard

Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography. / Manohar, Ashish; Colvert, Gabrielle M; Yang, James et al.

In: Circulation. Cardiovascular Imaging (Online), Vol. 15, No. 8, e014165, 08.2022.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

Manohar, A, Colvert, GM, Yang, J, Chen, Z, Ledesma-Carbayo, MJ, Kronborg, MB, Sommer, A, Nørgaard, BL, Nielsen, JC & McVeigh, ER 2022, 'Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography', Circulation. Cardiovascular Imaging (Online), vol. 15, no. 8, e014165. https://doi.org/10.1161/CIRCIMAGING.122.014165

APA

Manohar, A., Colvert, G. M., Yang, J., Chen, Z., Ledesma-Carbayo, M. J., Kronborg, M. B., Sommer, A., Nørgaard, B. L., Nielsen, J. C., & McVeigh, E. R. (2022). Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography. Circulation. Cardiovascular Imaging (Online), 15(8), [e014165]. https://doi.org/10.1161/CIRCIMAGING.122.014165

CBE

Manohar A, Colvert GM, Yang J, Chen Z, Ledesma-Carbayo MJ, Kronborg MB, Sommer A, Nørgaard BL, Nielsen JC, McVeigh ER. 2022. Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography. Circulation. Cardiovascular Imaging (Online). 15(8):Article e014165. https://doi.org/10.1161/CIRCIMAGING.122.014165

MLA

Vancouver

Manohar A, Colvert GM, Yang J, Chen Z, Ledesma-Carbayo MJ, Kronborg MB et al. Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography. Circulation. Cardiovascular Imaging (Online). 2022 Aug;15(8):e014165. doi: 10.1161/CIRCIMAGING.122.014165

Author

Manohar, Ashish ; Colvert, Gabrielle M ; Yang, James et al. / Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography. In: Circulation. Cardiovascular Imaging (Online). 2022 ; Vol. 15, No. 8.

Bibtex

@article{d35411fdccc74ccb9d5769959b0a6d07,
title = "Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography",
abstract = "BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure; however, 30% of patients do not respond to the treatment. We sought to derive patient-specific left ventricle maps of lead placement scores (LPS) that highlight target pacing lead sites for achieving a higher probability of CRT response.METHODS: Eighty-two subjects recruited for the ImagingCRT trial (Empiric Versus Imaging Guided Left Ventricular Lead Placement in Cardiac Resynchronization Therapy) were retrospectively analyzed. All 82 subjects had 2 contrast-enhanced full cardiac cycle 4-dimensional computed tomography scans: a baseline and a 6-month follow-up scan. CRT response was defined as a reduction in computed tomography-derived end-systolic volume ≥15%. Eight left ventricle features derived from the baseline scans were used to train a support vector machine via a bagging approach. An LPS map over the left ventricle was created for each subject as a linear combination of the support vector machine feature weights and the subject's own feature vector. Performance for distinguishing responders was performed on the original 82 subjects.RESULTS: Fifty-two (63%) subjects were responders. Subjects with an LPS≤Q1 (lower-quartile) had a posttest probability of responding of 14% (3/21), while subjects with an LPS≥ Q3 (upper-quartile) had a posttest probability of responding of 90% (19/21). Subjects with Q1<LPS<Q3 had a posttest probability of responding that was essentially unchanged from the pretest probability (75% versus 63%, P=0.2). An LPS threshold that maximized the geometric mean of true-negative and true-positive rates identified 26/30 of the nonresponders. The area under the curve of the receiver operating characteristic curve for identifying responders with an LPS threshold was 87%.CONCLUSIONS: An LPS map was defined using 4-dimensional computed tomography-derived features of left ventricular mechanics. The LPS correlated with CRT response, reclassifying 25% of the subjects into low probability of response, 25% into high probability of response, and 50% unchanged. These encouraging results highlight the potential utility of 4-dimensional computed tomography in guiding patient selection for CRT. The present findings need verification in larger independent data sets and prospective trials.",
keywords = "Cardiac Resynchronization Therapy, Clinical Trials as Topic, Heart Failure/diagnostic imaging, Humans, Lipopolysaccharides, Prospective Studies, Retrospective Studies, Tomography, Treatment Outcome, Ventricular Function, Left",
author = "Ashish Manohar and Colvert, {Gabrielle M} and James Yang and Zhennong Chen and Ledesma-Carbayo, {Maria J} and Kronborg, {Mads Brix} and Anders Sommer and N{\o}rgaard, {Bjarne L} and Nielsen, {Jens Cosedis} and McVeigh, {Elliot R}",
year = "2022",
month = aug,
doi = "10.1161/CIRCIMAGING.122.014165",
language = "English",
volume = "15",
journal = "Circulation. Cardiovascular Imaging (Online)",
issn = "1942-0080",
publisher = "Lippincott Williams & Wilkins",
number = "8",

}

RIS

TY - JOUR

T1 - Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography

AU - Manohar, Ashish

AU - Colvert, Gabrielle M

AU - Yang, James

AU - Chen, Zhennong

AU - Ledesma-Carbayo, Maria J

AU - Kronborg, Mads Brix

AU - Sommer, Anders

AU - Nørgaard, Bjarne L

AU - Nielsen, Jens Cosedis

AU - McVeigh, Elliot R

PY - 2022/8

Y1 - 2022/8

N2 - BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure; however, 30% of patients do not respond to the treatment. We sought to derive patient-specific left ventricle maps of lead placement scores (LPS) that highlight target pacing lead sites for achieving a higher probability of CRT response.METHODS: Eighty-two subjects recruited for the ImagingCRT trial (Empiric Versus Imaging Guided Left Ventricular Lead Placement in Cardiac Resynchronization Therapy) were retrospectively analyzed. All 82 subjects had 2 contrast-enhanced full cardiac cycle 4-dimensional computed tomography scans: a baseline and a 6-month follow-up scan. CRT response was defined as a reduction in computed tomography-derived end-systolic volume ≥15%. Eight left ventricle features derived from the baseline scans were used to train a support vector machine via a bagging approach. An LPS map over the left ventricle was created for each subject as a linear combination of the support vector machine feature weights and the subject's own feature vector. Performance for distinguishing responders was performed on the original 82 subjects.RESULTS: Fifty-two (63%) subjects were responders. Subjects with an LPS≤Q1 (lower-quartile) had a posttest probability of responding of 14% (3/21), while subjects with an LPS≥ Q3 (upper-quartile) had a posttest probability of responding of 90% (19/21). Subjects with Q1<LPS<Q3 had a posttest probability of responding that was essentially unchanged from the pretest probability (75% versus 63%, P=0.2). An LPS threshold that maximized the geometric mean of true-negative and true-positive rates identified 26/30 of the nonresponders. The area under the curve of the receiver operating characteristic curve for identifying responders with an LPS threshold was 87%.CONCLUSIONS: An LPS map was defined using 4-dimensional computed tomography-derived features of left ventricular mechanics. The LPS correlated with CRT response, reclassifying 25% of the subjects into low probability of response, 25% into high probability of response, and 50% unchanged. These encouraging results highlight the potential utility of 4-dimensional computed tomography in guiding patient selection for CRT. The present findings need verification in larger independent data sets and prospective trials.

AB - BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure; however, 30% of patients do not respond to the treatment. We sought to derive patient-specific left ventricle maps of lead placement scores (LPS) that highlight target pacing lead sites for achieving a higher probability of CRT response.METHODS: Eighty-two subjects recruited for the ImagingCRT trial (Empiric Versus Imaging Guided Left Ventricular Lead Placement in Cardiac Resynchronization Therapy) were retrospectively analyzed. All 82 subjects had 2 contrast-enhanced full cardiac cycle 4-dimensional computed tomography scans: a baseline and a 6-month follow-up scan. CRT response was defined as a reduction in computed tomography-derived end-systolic volume ≥15%. Eight left ventricle features derived from the baseline scans were used to train a support vector machine via a bagging approach. An LPS map over the left ventricle was created for each subject as a linear combination of the support vector machine feature weights and the subject's own feature vector. Performance for distinguishing responders was performed on the original 82 subjects.RESULTS: Fifty-two (63%) subjects were responders. Subjects with an LPS≤Q1 (lower-quartile) had a posttest probability of responding of 14% (3/21), while subjects with an LPS≥ Q3 (upper-quartile) had a posttest probability of responding of 90% (19/21). Subjects with Q1<LPS<Q3 had a posttest probability of responding that was essentially unchanged from the pretest probability (75% versus 63%, P=0.2). An LPS threshold that maximized the geometric mean of true-negative and true-positive rates identified 26/30 of the nonresponders. The area under the curve of the receiver operating characteristic curve for identifying responders with an LPS threshold was 87%.CONCLUSIONS: An LPS map was defined using 4-dimensional computed tomography-derived features of left ventricular mechanics. The LPS correlated with CRT response, reclassifying 25% of the subjects into low probability of response, 25% into high probability of response, and 50% unchanged. These encouraging results highlight the potential utility of 4-dimensional computed tomography in guiding patient selection for CRT. The present findings need verification in larger independent data sets and prospective trials.

KW - Cardiac Resynchronization Therapy

KW - Clinical Trials as Topic

KW - Heart Failure/diagnostic imaging

KW - Humans

KW - Lipopolysaccharides

KW - Prospective Studies

KW - Retrospective Studies

KW - Tomography

KW - Treatment Outcome

KW - Ventricular Function, Left

U2 - 10.1161/CIRCIMAGING.122.014165

DO - 10.1161/CIRCIMAGING.122.014165

M3 - Journal article

C2 - 35973012

VL - 15

JO - Circulation. Cardiovascular Imaging (Online)

JF - Circulation. Cardiovascular Imaging (Online)

SN - 1942-0080

IS - 8

M1 - e014165

ER -