{Reference Type}: Journal Article
{Title}: Impact of DCM-Causing Genetic Background on Long-Term Response to Cardiac Resynchronization Therapy.
{Author}: Dal Ferro M;Paldino A;Gregorio C;Bessi R;Zaffalon D;De Angelis G;Severini GM;Stolfo D;Gigli M;Brun F;Massa L;Korcova R;Salvatore L;Bianco E;Mestroni L;Merlo M;Zecchin M;Sinagra G;
{Journal}: JACC Clin Electrophysiol
{Volume}: 10
{Issue}: 7
{Year}: 2024 Jul 8
{Factor}: 6.124
{DOI}: 10.1016/j.jacep.2024.03.019
{Abstract}: <B>BACKGROUND: </B>Patients with nonischemic dilated cardiomyopathy (DCM), severe left ventricular (LV) dysfunction, and complete left bundle branch block benefit from cardiac resynchronization therapy (CRT). However, a large heterogeneity of response to CRT is described. Several predictors of response to CRT have been identified, but the role of the underlying genetic background is still poorly explored.<BR><B>OBJECTIVE: </B>In the present study, the authors sought to define differences in LV remodeling and outcome prediction after CRT when stratifying patients according to the presence or absence of DCM-causing genetic background.<BR><B>METHODS: </B>From our center, 74 patients with DCM subjected to CRT and available genetic testing were retrospectively enrolled. Carriers of causative monogenic variants in validated DCM-causing genes, and/or with documented family history of DCM, were classified as affected by genetically determined disease (GEN+DCM) (n = 25). Alternatively, by idiopathic dilated cardiomyopathy (idDCM) (n = 49). The primary outcome was long-term LV remodeling and prevalence of super response to CRT (evaluated at 24-48 months after CRT); the secondary outcome was heart failure-related death/heart transplant/LV assist device.<BR><B>RESULTS: </B>GEN+DCM and idDCM patients were homogeneous at baseline with the exception of QRS duration, longer in idDCM. The median follow-up was 55 months. Long-term LV reverse remodeling and the prevalence of super response were significantly higher in the idDCM group (27% in idDCM vs 5% in GEN+DCM; P = 0.025). The heart failure-related death/heart transplant/LV assist device outcome occurred more frequently in patients with GEN+DCM (53% vs 24% in idDCM; P = 0.028).<BR><B>CONCLUSIONS: </B>Genotyping contributes to the risk stratification of patients with DCM undergoing CRT implantation in terms of LV remodeling and outcomes.