Available data suggest presence of reverse remodeling predicts cardiac resynchronization therapy (CRT) responders in HF patients. Factors that are associated with favorable reserve remodeling were used to predict CRT responders in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy) trial (69). Using regression analysis in the CRT with ICD (CRT-D) arm of the trial, 7 factors associated with a favorable echocardiographic response (defined as a 10% reduction in left ventricular end-diastolic volume at 1 year) to CRT-D therapy were first identified—female sex, nonischemic cardiomyopathy, QRS duration ≥150 ms, the presence of left bundle branch block on baseline ECG, hospitalization for HF at any time before enrollment, baseline left ventricular end-diastolic volume ≥125 ml/m2, and baseline left atrial volume <40 ml/m2. Each of the 7 factors was assigned a numerical score on the basis of its relative effect in the regression model. The factor with the lowest effect, prior HF hospitalization, was assigned the lowest score of 1; the intermediate factors, which included female sex, nonischemic cardiomyopathy, left bundle branch block, QRS interval ≥150 ms, and left ventricular end-diastolic volume, were assigned a score of 2; the highest factor, left atrial volume, was assigned a score of 3. A response score was constructed by adding the number values of the factors identified in each patient. Four patient groups were created on the basis of the response scores. Group 1, the lowest score quartile, had a score of 0 to 4, Group 2 had a score of 5 to 6, Group 3 had a score of 7 to 8, and Group 4, the highest quartile, had a score of 9 to 14. Cox proportional hazards regression modeling showed that when compared to the ICD-only arm, CRT-D patients in Group 2 and higher showed a significant reduction in the risk of HF or death, whereas Group 1 patients derived no benefit. The degree of reduction was incremental between groups with a 33% (p = 0.04), 36% (p = 0.03), and 69% (p < 0.001) risk reduction for Groups 2, 3, and 4, respectively. This analysis provides clinicians with a very helpful algorithm in selecting HF patients with a better chance of responding to CRT.