New-onset XXXX -associated @entity296 and left ventricular ejection fraction response to guideline-directed therapies: The NEOLITH study.

@entity296 @entity1002 @entity714
BACKGROUND: @entity1002 ( @entity1002 ) response to guideline-directed medical therapy (GDMT) and to early cardiac resynchronization therapy (CRT) in new-onset @entity296 ( @entity296 ) and @entity714 ( @entity714 ) is not well described. CRT is recommended if @entity1002 remains  <=35% after at least 3 months of GDMT. OBJECTIVE: The purpose of this study was to describe @entity1002 response to GDMT at 3 months and to early CRT in new-onset @entity714 -associated idiopathic @entity296 . METHODS: A retrospective cohort study was performed in subjects with new-onset idiopathic @entity296 , @entity1002  <=35%, and @entity714 or narrow (<120 ms) QRS complex morphology. @entity1002 response between groups was evaluated with log-binomial and linear regression. @entity1002 response within groups was evaluated using the paired Student t test. RESULTS: In 102 subjects (70 with narrow QRS complex and 32 with @entity714 ), post-GDMT @entity1002 was >35% in 39 narrow QRS complex subjects (56%) and 2 @entity714 subjects (6%) (P < .0001). The absolute difference between post-GDMT @entity1002 and initial @entity1002 was greater in the narrow QRS complex group (16.1%    14.6% vs 3.3%    10.7%; P < .0001). Narrow QRS complex, referenced to @entity714 , was significantly associated with post-GDMT @entity1002 >35% (relative risk 10.30; 95% confidence interval 2.63-40.27; P = .0008) and absolute difference between post-GDMT @entity1002 and initial @entity1002 (b = 16.296; standard error = 2.977; P < .0001) in final multivariable analyses. CRT super-response, defined as post-CRT @entity1002 >= 50%, was observed in 8 of @entity714 subjects (35%) who received CRT. CONCLUSION: GDMT did not significantly improve @entity1002 in new-onset @entity714 -associated idiopathic @entity296 at 3 months. Most remained candidates for CRT, and a high percentage were super-responders. Optimal timing for CRT implantation requires further investigation.
