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Trenson S, Voros G, Martens P, Ingelaere S, Betschart P, Voigt JU, Dupont M, Breitenstein A, Steffel J, Willems R, Ruschitzka F, Mullens W, Winnik S, Vandenberk B. Long-term outcome after upgrade to cardiac resynchronization therapy: A propensity score-matched analysis. Eur J Heart Fail 2024; 26:511-520. [PMID: 37905357 DOI: 10.1002/ejhf.3073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023] Open
Abstract
AIM Cardiac resynchronization therapy (CRT) is a cornerstone in the management of chronic heart failure in patients with a broad or paced QRS. However, data on long-term outcome after upgrade to CRT are scarce. METHODS AND RESULTS This international, multicentre retrospective registry included 2275 patients who underwent a de novo or upgrade CRT implantation with a mean follow-up of 3.6 ± 2.7 years. The primary composite endpoint included all-cause mortality, heart transplantation, or ventricular assist device implantation. The secondary endpoint was first heart failure admission. Multivariable Cox regression and propensity score matching (PSM) analyses were performed. Patients who underwent CRT upgrade (n = 605, 26.6%) were less likely female (19.7% vs. 28.8%, p < 0.001), more often had ischeemic cardiomyopathy (49.8% vs. 40.2%, p < 0.001), and had worse renal function (median estimated glomerular filtration rate 50.3 ml/min/1.73 m2 [35.8-69.5] vs. 59.9 ml/min/1.73 m2 [43.0-76.5], p < 0.001). The incidence rate of the composite endpoint was 10.8%/year after CRT upgrade versus 7.1%/year for de novo implantations (p < 0.001). PSM for the primary endpoint resulted in 488 pairs. After propensity score matching, upgrade to CRT was associated with a higher chance to reach the composite endpoint (multivariable hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.08-1.70), for both upgrade from pacemaker (multivariable HR 1.33, 95% CI 1.03-1.70) and implantable cardioverter-defibrillator (ICD) (multivariable HR 1.40, 95% CI 1.01-1.95). PSM for the secondary endpoint resulted in 277 pairs. After PSM, upgrade to CRT was associated with a higher chance for heart failure admission (HR 1.74, 95% CI 1.26-2.41). CONCLUSION In this retrospective analysis, the outcome of patients who underwent upgrades to CRT differed significantly from patients who underwent de novo CRT implantation, particularly for upgrades from ICD. Importantly, this difference in outcome does not imply a causal relation between therapy and outcome but rather a difference between two different patient populations.
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Affiliation(s)
- Sander Trenson
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, Sint-Jan Hospital Bruges, Bruges, Belgium
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Gabor Voros
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Martens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | | | - Pascal Betschart
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Jens-Uwe Voigt
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Matthias Dupont
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | | | - Jan Steffel
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Frank Ruschitzka
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Wilfried Mullens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Department of Life Sciences, Hasselt University, Hasselt, Belgium
| | - Stephan Winnik
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Bert Vandenberk
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
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Mandoli GE, Pastore MC, Giannoni A, Benfari G, Dini FL, Rosa G, Pugliese NR, Taddei C, Correale M, Brunetti ND, Mazzeo P, Carluccio E, Mengoni A, Guaricci AI, Piscitelli L, Citro R, Ciccarelli M, Novo G, Corrado E, Pasquini A, Loria V, De Carli G, Degiovanni A, Patti G, Santoro C, Moderato L, Cicoira M, Canepa M, Malagoli A, Emdin M, Cameli M. Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril-Valsartan: A Multicenter Echocardiographic Registry. ESC Heart Fail 2023; 10:846-857. [PMID: 36448244 PMCID: PMC10053272 DOI: 10.1002/ehf2.14155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 09/01/2022] [Accepted: 09/08/2022] [Indexed: 12/03/2022] Open
Abstract
AIMS Sacubitril/valsartan has changed the treatment of heart failure with reduced ejection fraction (HFrEF), due to the positive effects on morbidity and mortality, partly mediated by left ventricular (LV) reverse remodelling (LVRR). The aim of this multicenter study was to identify echocardiographic predictors of LVRR after sacubitril/valsartan administration. METHODS AND RESULTS Patients with HFrEF requiring therapy with sacubitril/valsartan from 13 Italian centres were included. Echocardiographic parameters including LV global longitudinal strain (GLS) and global peak atrial longitudinal strain by speckle tracking echocardiography were measured to find the predictors of LVRR [= LV end-systolic volume reduction ≥10% and ejection fraction (LVEF) improvement ≥10% at follow-up] at 6 month follow-up as the primary endpoint. Changes in symptoms [New York Heart Association (NYHA) class] and neurohormonal activations [N-terminal pro-brain natriuretic peptide (NT-proBNP)] were also evaluated as secondary endpoints; 341 patients (excluding patients with poor acoustic windows and missing data) were analysed (mean age: 65 ± 10 years; 18% female, median LVEF 30% [inter-quartile range: 25-34]). At 6 month follow-up, 82 (24%) patients showed early complete response (LVRR and LVEF ≥ 35%), 55 (16%) early incomplete response (LVRR and LVEF < 35%), and 204 (60%) no response (no LVRR and LVEF < 35%). Non-ischaemic aetiology, a lower left atrial volume index, and a higher GLS were all independent predictors of LVRR at multivariable logistic analysis (all P < 0.01). A baseline GLS < -9.3% was significantly associated with early response (area under the curve 0.75, P < 0.0001). Left atrial strain was the best predictor of positive changes in NYHA class and NT-proBNP (all P < 0.05). CONCLUSIONS Speckle tracking echocardiography parameters at baseline could be useful to predict LVRR and clinical response to sacubitril-valsartan and could be used as a guide for treatment in patients with HFrEF.
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Affiliation(s)
- Giulia Elena Mandoli
- Division of Cardiology, Department of Medical BiotechnologiesUniversity of SienaViale Bracci 1SienaItaly
| | - Maria Concetta Pastore
- Division of Cardiology, Department of Medical BiotechnologiesUniversity of SienaViale Bracci 1SienaItaly
| | - Alberto Giannoni
- Cardiology and Cardiovascular Medicine DepartmentFondazione Toscana G. MonasterioPisaItaly
- Institute of Life SciencesScuola Superiore Sant'AnnaPisaItaly
| | - Giovanni Benfari
- Section of Cardiology, Department of MedicineUniversity of VeronaVeronaItaly
| | | | - Gianmarco Rosa
- Department of Internal Medicine and Medical SpecialitiesUniversity of GenoaGenoaItaly
| | | | - Claudia Taddei
- Cardiology and Cardiovascular Medicine DepartmentFondazione Toscana G. MonasterioPisaItaly
| | - Michele Correale
- Cardiology DepartmentPoliclinico Riuniti University HospitalFoggiaItaly
| | | | - Pietro Mazzeo
- Department of Medical and Surgical SciencesUniversity of FoggiaFoggiaItaly
| | - Erberto Carluccio
- Cardiology and Cardiovascular Pathophysiology—Heart Failure Unit, ‘Santa Maria della Misericordia’ HospitalUniversity of PerugiaPerugiaItaly
| | - Anna Mengoni
- Cardiology and Cardiovascular Pathophysiology—Heart Failure Unit, ‘Santa Maria della Misericordia’ HospitalUniversity of PerugiaPerugiaItaly
| | - Andrea Igoren Guaricci
- University Cardiology Unit, Cardiothoracic DepartmentPolyclinic University HospitalBariItaly
| | - Laura Piscitelli
- University Cardiology Unit, Cardiothoracic DepartmentPolyclinic University HospitalBariItaly
| | - Rodolfo Citro
- Cardio‐Thoracic‐Vascular DepartmentUniversity Hospital San Giovanni di Dio e Ruggi d'AragonaSalernoItaly
| | - Michele Ciccarelli
- Department of Medicine, Surgery and DentistryUniversity of SalernoBaronissiItaly
| | - Giuseppina Novo
- Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University Hospital Paolo GiacconeUniversity of PalermoPalermoItaly
| | - Egle Corrado
- Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University Hospital Paolo GiacconeUniversity of PalermoPalermoItaly
| | - Annalisa Pasquini
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro CuoreRomeItaly
| | - Valentina Loria
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro CuoreRomeItaly
| | - Giuseppe De Carli
- Division of Cardiology, Department of Medical BiotechnologiesUniversity of SienaViale Bracci 1SienaItaly
| | - Anna Degiovanni
- Department of Thoracic, Heart and Vascular DiseasesMaggiore della Carità HospitalNovaraItaly
| | - Giuseppe Patti
- Department of Thoracic, Heart and Vascular DiseasesMaggiore della Carità HospitalNovaraItaly
- Department of Translational MedicineUniversity of Piemonte OrientaleNovaraItaly
| | - Ciro Santoro
- Department of Advanced Biomedical ScienceFederico II University HospitalNaplesItaly
| | - Luca Moderato
- Cardiology DepartmentOspedale Guglielmo da SalicetoPiacenzaItaly
| | | | - Marco Canepa
- Cardiovascular Disease UnitIRCCS Ospedale Policlinico San Martino, IRCCS Italian Cardiovascular NetworkGenoaItaly
- Department of Internal MedicineUniversity of GenoaGenoaItaly
| | - Alessandro Malagoli
- Division of Cardiology, Nephro‐Cardiovascular Department, Baggiovara HospitalUniversity of Modena and Reggio EmiliaModenaItaly
| | - Michele Emdin
- Cardiology and Cardiovascular Medicine DepartmentFondazione Toscana G. MonasterioPisaItaly
- Institute of Life SciencesScuola Superiore Sant'AnnaPisaItaly
| | - Matteo Cameli
- Division of Cardiology, Department of Medical BiotechnologiesUniversity of SienaViale Bracci 1SienaItaly
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Sabitov YT, Dusypov AA, Abdrakhmanov AS, Orekhov AY, Turubaev EM. [Resynchronization Therapy for Chronic Heart Failure: Diagnostic and Therapeutic Approaches]. KARDIOLOGIYA 2019; 59:84-91. [PMID: 31849315 DOI: 10.18087/cardio.2019.12.n391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 08/19/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022]
Abstract
Chronic heart failure (CHF) remains one of the most important problems of modern cardiology. One of the effective treatment methods is resynchronization therapy (RT). The article presents an analysis of literature data on the effectiveness of RT in improving the quality of life, reducing the number of hospitalizations and mortality in patients with heart failure with severe left ventricular systolic dysfunction and expanding QRS complex, and also discusses key methods for optimizing RT.
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Zavadovsky KV, Mishkina AI, Lebedev DI, Gulya MO, Varlamova YV, Lishmanov YB, Popov SV. [123 I-MIBG scintigraphy in the assessment of heart failure prognosis and effectiveness of cardiac resynchronization therapy]. ACTA ACUST UNITED AC 2019; 60:122-130. [PMID: 32345208 DOI: 10.18087/cardio.2020.2.n324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 11/18/2022]
Abstract
Cardiac resynchronization therapy (CRT) is one of the methods of treating patients with chronic heart failure, which can reduce the mortality rate of this group. Scintigraphic assessment of sympathetic myocardial innervation allows us to evaluate the heart failure prognosis and the effectiveness of interventional treatment. The method is based on use of the radiopharmaceutical 123 I-methiodiobenzylguanidine (123 I-MIBG), which is a structural analogue of norepinephrine and is able to selectively accumulate in the sympathetic nerve endings. This review includes a brief description of norepinephrine metabolism and pharmacokinetics of 123 I-MIBG in the sympathetic nerve ending, a brief description of the study methodology and the clinical significance of this method in patients with heart failure. Particular attention is paid to the possibilities of using this method in patients with severe chronic heart failure before and after CRT.
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Affiliation(s)
- K V Zavadovsky
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - A I Mishkina
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - D I Lebedev
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - M O Gulya
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - Yu V Varlamova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - Yu B Lishmanov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - S V Popov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
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Uhm JS, Oh J, Cho IJ, Park M, Kim IS, Jin MN, Bae HJ, Yu HT, Kim TH, Pak HN, Lee MH, Joung B, Kang SM. Left Ventricular End-Systolic Volume Can Predict 1-Year Hierarchical Clinical Composite End Point in Patients with Cardiac Resynchronization Therapy. Yonsei Med J 2019; 60:48-55. [PMID: 30554490 PMCID: PMC6298892 DOI: 10.3349/ymj.2019.60.1.48] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to elucidate which echocardiographic criteria at three time points, for cardiac resynchronization therapy (CRT) response, are accurate in discriminating the hierarchical clinical composite end point (HCCEP). MATERIALS AND METHODS We included 120 patients (age, 66.1±12.6 years; men, 54.2%) who underwent CRT implantation for heart failure (HF). Echocardiography was performed before and at 3, 6, and 12 months after CRT implantation. The 1-year HCCEP included all-cause mortality, hospitalization for HF, and New York Heart Association functional class for 12 months. CRT response criteria were decrease in left ventricular (LV) end-systolic volume (LVESV) >15%, decrease in LV end-diastolic volume >15%, absolute increase in LV ejection fraction (LVEF) ≥5%, relative increase in LVEF ≥15%, and decrease in mitral regurgitation ≥1 grade. Temporal changes in CRT response rates, accuracy of CRT response criteria at each time and cutoff value for the discrimination of improvement in HCCEP, and agreements with improvement in HCCEP were analyzed. RESULTS HCCEP improvement rates were 65.8% in total group. In nonischemic group, CRT response rates according to all echocardiographic criteria significantly increased with time. In ischemic group, CRT response rate did not significantly change with time. In total group, ΔLVESV at 6 months (ΔLVESV6) had the most significant accuracy for the discrimination of HCCEP (area under the curve=0.781). The optimal cutoff value of ΔLVESV6 was 13.5% (sensitivity=0.719, specificity=0.719). ΔLVESV6 had fair agreement with HCCEP (κ=0.391, p<0.001). CONCLUSION ΔLVESV6 is the most useful echocardiographic CRT response criterion for the prediction of 1-year HCCEP.
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Affiliation(s)
- Jae Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jaewon Oh
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - In Jeong Cho
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Minsu Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - In Soo Kim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Moo Nyun Jin
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Han Joon Bae
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hui Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Moon Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Seok Min Kang
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Costanzo MR, Ponikowski P, Coats A, Javaheri S, Augostini R, Goldberg LR, Holcomb R, Kao A, Khayat RN, Oldenburg O, Stellbrink C, McKane S, Abraham WT. Phrenic nerve stimulation to treat patients with central sleep apnoea and heart failure. Eur J Heart Fail 2018; 20:1746-1754. [PMID: 30303611 PMCID: PMC6607512 DOI: 10.1002/ejhf.1312] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 11/05/2022] Open
Abstract
AIMS The presence of central sleep apnoea (CSA) is associated with poor prognosis in patients with heart failure (HF). The aim of this analysis was to evaluate if using phrenic nerve stimulation to treat CSA in patients with CSA and HF was associated with changes in HF-specific metrics. METHODS AND RESULTS All patients randomized in the remedē System Pivotal Trial and identified at baseline with HF were included (n = 96). Effectiveness data from treatment and former control groups were pooled based on months since therapy activation. Changes from baseline to 6 and 12 months in sleep metrics, Epworth Sleepiness Scale, patient global assessment health-related quality of life, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and echocardiographic parameters are reported. HF hospitalization, cardiovascular death, and the composite of HF hospitalization or cardiovascular death within 6 months are reported by the original randomized group assignment for safety assessment. Sleep metrics and quality of life improved from baseline to 6 and 12 months. At 12 months, MLHFQ scores changed by -6.8 ± 20.0 (P = 0.005). The 6-month rate of HF hospitalization was 4.7% in treatment patients (standard error = 3.3) and 17.0% in control patients (standard error = 5.5) (P = 0.065). Reported adverse events were as expected for a transvenous implantable system. CONCLUSIONS Phrenic nerve stimulation reduces CSA severity in patients with HF. In parallel, this CSA treatment was associated with benefits on HF quality of life.
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Affiliation(s)
| | | | | | | | | | | | | | - Andrew Kao
- Mid America Heart Institute, Kansas City, MO, USA
| | | | - Olaf Oldenburg
- Bad Oeynhausen Heart and Diabetes Center, Bad Oeynhausen, Germany
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7
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Response and outcomes of cardiac resynchronization therapy in patients with renal dysfunction. J Interv Card Electrophysiol 2018; 51:237-244. [PMID: 29460235 DOI: 10.1007/s10840-018-0330-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/06/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Renal dysfunction is often associated with chronic heart failure, leading to increased morbi-mortality. However, data regarding these patients after cardiac resynchronization therapy (CRT) is sparse. We sought to evaluate response and long-term mortality in patients with heart failure and renal dysfunction and assess renal improvement after CRT. METHODS We analyzed 178 consecutive patients who underwent successful CRT device implantation (age 64 ± 11 years; 69% male; 92% in New York Heart Association (NYHA) functional class ≥ III; 34% with ischemic cardiomyopathy). Echocardiographic response was defined as ≥ 15% reduction in left ventricular end-systolic diameter and clinical response as a sustained improvement of at least one NYHA functional class. Renal dysfunction was defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2. RESULTS Renal dysfunction was present in 34.7%. Renal dysfunction was not an independent predictor of echocardiographic response (OR 1.109, 95% CI 0.713-1.725, p 0.646) nor clinical response (OR 1.003; 95% CI 0.997-1.010; p 0.324). During follow-up (mean 55.2 ± 32 months), patients with eGFR < 60mL/min/1.73 m2 had higher overall mortality (HR 4.902, 95% CI 1.118-21.482, p 0.035). However, clinical response in patients with renal dysfunction was independently associated with better long-term survival (HR 0.236, 95% CI 0.073-0.767, p 0.016). Renal function was significantly improved in patients who respond to CRT (ΔeGFR + 5.5 mL/min/1.73 m2 at baseline vs. follow-up, p 0.049), while this was not evident in nonresponders. Improvements in eGFR of at least 10 mL/min/1.73 m2 were associated with improved survival in renal dysfunction patients (log-rank p 0.036). CONCLUSION Renal dysfunction was associated with higher long-term mortality in CRT patients, though, it did not influence echocardiographic nor functional response. Despite worse overall prognosis, renal dysfunction patients who are responders showed long-term survival benefit and improvement in renal function following CRT.
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António N. Reduction of systemic inflammation after cardiac resynchronization therapy: A new form of response? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.repce.2018.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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9
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António N. Redução da inflamação sistémica após terapêutica de ressincronização cardíaca: uma nova forma de resposta? Rev Port Cardiol 2018. [DOI: 10.1016/j.repc.2018.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Fonseca C. Reverse remodeling: Much room for research. Rev Port Cardiol 2016; 35:261-4. [PMID: 27173744 DOI: 10.1016/j.repc.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Cândida Fonseca
- Unidade de Insuficiência Cardíaca, Hospital de S. Francisco Xavier, Centro Hospitalar Lisboa Ocidental E.P.E., Lisboa, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
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11
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Fonseca C. Reverse remodeling: Much room for research. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2016.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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