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Supplementary Table 1.
Patient
1
2
3
4
5
6
7
8
9
Reason for Exclusion
Acute
PostCoronary Cardiogenic Cardiac
Syndrome
Shock
Arrest
X
X
X
X
X
X
X
X
X
X
Supplementary Table 2.
2A
Univariate Predictors of Composite Outcome
Variable
Beta-Coefficient
P-value
Age > 65 years
-0.17
0.65
Female Gender
-0.15
0.78
LBBB
-0.53
0.16
LVEF <25%
0.82
0.08
QRS > 150 ms
-0.62
0.10
Diabetes Mellitus
0.11
0.76
Ischemic etiology
-0.52
0.16
Chronic renal insufficiency (stage ≥
0.74
0.13
III)
Any atrial fibrillation
0.07
0.85
Apical lead
-0.45
0.40
Anterior lead
0.184
0.76
β-adrenergic receptor antagonist
-0.93
0.04
Diuretic, any
0.46
0.53
ACE inhibitor or ARB
-0.75
0.12
Aldosterone blocker
0.31
0.41
Digoxin
0.59
0.11
mPAP ≥ 25 mmHg
1.60
0.03
mPAP, per 10 mmHg increase
0.39
0.03
PCWP, mmHg
0.03
0.07
5
PVR, dynes*sec/cm
0.003
0.01
TPG ≥ 12 mmHg
1.1
0.004
Cardiac Output, L/min
-0.30
0.07
RV dilation, baseline
1.4
0.002
MR, grade
0.78
0.005
TR, grade
0.45
0.04
LVIDd, mm
0.007
0.73
LBBB, left bundle branch block; stage III/IV indicates degree of chronic kidney disease as reflected by
estimated glomerular filtration rate (see Methods); ACE, angiotensin converting enzyme; ARB,
angiotensin receptor blocker; LVEF, left ventricular ejection fraction; mPAP, mean pulmonary artery
pressure; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistance; TPG,
trans-pulmonary gradient; RV, right ventricular; MR, mitral regurgitation; TR, tricuspid regurgitation;
LVIDd, left ventricular internal diameter at end-diastole.
2B
Univariate Predictors of All-Cause Mortality
Variable
Beta-Coefficient
P-value
Age >65 years
0.56
0.22
Female Gender
-0.22
0.72
LBBB
-0.85
0.05
LVEF <25%
0.68
0.18
QRS >150 ms
-0.74
0.09
Diabetes Mellitus
0.04
0.93
Ischemic etiology
0.12
0.77
Chronic renal insufficiency (stage ≥
0.74
0.03
III)
Any atrial fibrillation
0.22
0.62
Apical lead
-0.50
0.42
Anterior lead
0.04
0.96
β-adrenergic receptor antagonist
-0.94
0.06
Diuretic, any
0.92
0.37
ACE inhibitor or ARB
-0.64
0.24
Aldosterone blocker
0.05
0.92
Digoxin
0.40
0.34
mPAP ≥25 mmHg
0.127
0.09
mPAP, per 10 mmHg increase
0.301
0.13
PCWP, mmHg
0.031
0.14
5
PVR, dynes*sec/cm
0.0024
0.03
TPG ≥ 12 mmHg
1.15
0.009
Cardiac Output, L/min
-0.42
0.03
RV dilation, baseline
1.15
0.02
MR, grade
0.83
0.008
TR, grade
0.59
0.02
LVIDd, mm
-0.008
0.76
LBBB, left bundle branch block; stage III/IV indicates degree of chronic kidney disease as reflected by
estimated glomerular filtration rate (see Methods); ACE, angiotensin converting enzyme; ARB,
angiotensin receptor blocker; LVEF, left ventricular ejection fraction; mPAP, mean pulmonary artery
pressure; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistance; TPG,
trans-pulmonary gradient; RV, right ventricular; MR, mitral regurgitation; TR, tricuspid regurgitation;
LVIDd, left ventricular internal diameter at end-diastole.
Supplementary Table 3. Clinical characteristics stratified by presence and timing of RHC
RHC ≤6
months prior
to CRT
(n=101)
No RHC
prior to
CRT
(n=182)
Age – Years
RHC >6
months
prior to
CRT
(n=117)
70±12
66±13
70±12‡
Male Sex - %
78
82
83
QRS (msec)
161±26
159±31
161±29
24±7
23±7
23±7
54
54
51
3.1±0.3
3.2±0.4
3.1±0.3‡
Diabetes - %
41
45
36
Any Atrial Fibrillation - %
65
60
60
CKD (stage ≥ III) - %
76
72
72
Ischemic etiology, cardiomyopathy - %
54
58
60
Any Diuretic
94
89
84†
ACE Inhibitor or ARB
76*
90
78‡
β-Adrenergic Receptor Antagonist
86
90
89
Spironolactone – Aldo Blocker
34
42
31
Digoxin
47
33
47
Characteristic
LV Ejection Fraction, %
LBBB - %
NYHA – class
Heart Failure Pharmacotherapy - %
Continuous variables are presented as mean ± standard deviation (STD) if normally distributed or
median[interquartile range] if not normally distributed. * Indicates P<0.05 for comparison of RHC > vs.
≤6 months prior to CRT, † indicates P<0.05 for RHC >6 months prior to CRT vs. No RHC, ‡ indicates
P<0.05 for comparison of RHC ≤ 6months prior to CRT vs. No RHC. TPG, trans-pulmonary gradient;
PH, pulmonary hypertension; LBBB, left bundle branch block; CKD, chronic kidney disease (stage
defined by estimated glomerular filtration rate, see Methods); ACE, angiotensin converting enzyme;
ARB, angiotensin receptor blocker; RHC, right heart catheterization; CRT, cardiac resynchronization
therapy.
Supplementary Figure 1. Right Heart Catheterization Characteristics and Clinical Outcome
Kaplan-Meier estimates of the probability of survival free of the composite clinical outcome (death,
heart transplantation, left ventricular assist device placement) assessed at 2 years. (A) Comparison
between patients who did not receive a right heart catheterization (RHC) prior to CRT and those that
did undergo RHC prior to CRT (either ≤6 months prior to implant or >6 months prior to implant). Of
patients who received RHC ≤6 months prior to implant, (B) comparison between those in whom RHC
occurred in the ambulatory setting vs. non-ambulatory setting and (C) comparison of outcome
stratified by clinical indication for RHC.
Supplementary Figure 1
Freedom from Death/Transplant/LVAD
A
No RHC (n=182)
RHC ≤ 6 months prior to CRT (n=101)
RHC > 6 months prior to CRT (n=117)
No RHC vs. RHC ≤ 6 months, log-rank p = 0.16
RHC >6 mo vs. RHC ≤ 6 months, log-rank p = 0.18
Time (months)
Supplementary Figure 1
Freedom from Death/Transplant/LVAD
B
Ambulatory (n=47)
Non-ambulatory (n=54)
Log-rank p= (0.86)
Time (months)
Supplementary Figure 1
Freedom from Death/Transplant/LVAD
C
Heart Failure Symptomatology (n=71)
Angina (n=19)
Arrhythmia/ICD Therapy or Other (n=11)
Log-rank p= (0.83)
Time (months)