Evidence map›Paper›PMID 38879456›Full record

Trial reportJournal of the American Heart Association2024

Heart Size Difference Drives Sex-Specific Response to Cardiac Resynchronization Therapy: A Post Hoc Analysis of the MORE-MPP CRT Trial.

Nadeev Wijesuriya, Vishal Mehta, Felicity De Vere, Sandra Howell, Steven A Niederer, Haran Burri, Johannes Sperzel, Leonardo Calo, Bernard Thibault, Wenjiao Lin and 6 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Redefining response to cardiac resynchronization therapy: a post hoc analysis of the MORE-CRT MPP trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  2. Review
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Nadeev WijesuriyaKing's College London London UK.ORCID 0000-0001-7893-0708
Vishal MehtaKing's College London London UK.ORCID 0000-0001-6140-068X
Felicity De VereKing's College London London UK.ORCID 0000-0002-5588-4451
Sandra HowellKing's College London London UK.ORCID 0000-0002-3925-2913
Steven A NiedererKing's College London London UK.ORCID 0000-0002-4612-6982
Haran BurriUniversity Hospital of Geneva Geneva Switzerland.ORCID 0000-0002-4393-5338
Johannes SperzelKerckhoff-Klinik Heart Center Bad Nauheim Germany.
Leonardo CaloCasilino Policlinico Rome Italy.ORCID 0000-0002-4752-8617
Bernard ThibaultMontreal Heart Institute Montreal QC Canada.
Wenjiao LinAbbott Plano TX USA.
Kwangdeok LeeAbbott Plano TX USA.
Andrea GrammaticoAbbott Plano TX USA.
Niraj VarmaCleveland Clinic London UK.ORCID 0000-0003-2296-2596
Marianne GwechenbergerMedical University of Vienna Vienna Austria.
Christophe LeclercqCHRU Pontchaillou Rennes France.ORCID 0000-0002-4399-5568
Christopher A RinaldiKing's College London London UK.

Funding

Using Atrial Mechanics To Identify Fibrosis In Patients with Atrial FibrillationR01HL152256 · NHLBI · STANFORD UNIVERSITY · PI ENNIS, DANIEL B · 2020 to 2023
$2.8M
NHLBI NIH HHS R01 HL152256
6 · The paper itself

Abstract

backgroundStudies have reported that female sex predicts superior cardiac resynchronization therapy (CRT) response. One theory is that this association is related to smaller female heart size, thus increased relative dyssynchrony at a given QRS duration (QRSd). Our objective was to investigate the mechanisms of sex-specific CRT response relating to heart size, relative dyssynchrony, cardiomyopathy type, QRS morphology, and other patient characteristics. METHODS AND

resultsThis is a post hoc analysis of the MORE-CRT MPP (More Response on Cardiac Resynchronization Therapy with Multipoint Pacing)  trial (n=3739, 28% women), with a subgroup analysis of patients with nonischemic cardiomyopathy and left bundle-branch block (n=1308, 41% women) to control for confounding characteristics. A multivariable analysis examined predictors of response to 6 months of conventional CRT, including sex and relative dyssynchrony, measured by QRSd/left ventricular end-diastolic volume (LVEDV). Women had a higher CRT response rate than men (70.1% versus 56.8%,

conclusionsIn the nonischemic cardiomyopathy left bundle-branch block population, increased relative dyssynchrony in women, who have smaller heart sizes than their male counterparts, is a driver of sex-specific CRT response, particularly at QRSd <150 ms. Women may benefit from CRT at a QRSd <130 ms, opening the debate on whether sex-specific QRSd cutoffs or QRS/LVEDV measurement should be incorporated into clinical guidelines.

Indexed as

Bundle-Branch BlockCardiac Resynchronization TherapyHeart FailureAgedCardiomyopathiesElectrocardiographyFemaleHeartHumansMaleMiddle AgedOrgan SizeSex FactorsStroke VolumeTreatment OutcomeVentricular Function, Leftcardiac resynchronization therapyheart failuresex differences

Identifiers

PMID38879456
PMCPMC11255746

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.