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- Title
Prognostic predictors and echocardiographic time course after device replacement in patients treated chronically with cardiac resynchronization therapy devices.
- Authors
Nagase, Takahiko; Ishiguro, Maya; Mabuchi, Kei; Seki, Ruiko; Asano, So; Fukunaga, Hiroshi; Inoue, Kanki; Sekiguchi, Yukio; Tanizaki, Kohei; Nanasato, Mamoru; Iguchi, Nobuo; Nitta, Junichi; Isobe, Mitsuaki
- Abstract
The prognostic predictors of death or heart failure hospitalization and the echocardiographic response after initial cardiac resynchronization therapy (CRT) device replacement (CRT-r) remain unclear. We evaluated the predictors and the echocardiographic time course in patients after CRT-r. Consecutive 60 patients underwent CRT-r because of battery depletion. Patients were divided into two groups depending on the chronic echocardiographic response to CRT (left ventricular end-systolic volume [LVESV] reduction of ≥ 15%) at the time of CRT-r: CRT responders (group A; 35 patients) and CRT nonresponders (group B; 25 patients). The primary endpoint was a composite of death from any cause or heart failure hospitalization. Changes in LVESV and left ventricular ejection fraction (LVEF) after CRT-r were also analyzed. During the mean follow-up of 46 ± 33 months after CRT-r, the primary endpoint occurred more frequently in group B (group A versus group B; 8/35 [23%] patients versus 19/25 [76%] patients, p < 0.001). No significant changes in LVESV and LVEF were observed at the mean of 46 ± 29 months after CRT-r in both groups. A multivariate analysis identified echocardiographic nonresponse to CRT, chronic kidney disease, atrial fibrillation, and New York Heart Association functional class III or IV at the time of CRT-r as independent predictors of the primary endpoint in all patients. Residual echocardiographic nonresponse, comorbidities, and heart failure symptoms at the time of CRT-r predict the subsequent very long-term prognosis after CRT-r. No further echocardiographic response to CRT was found after CRT-r.
- Subjects
CARDIAC pacing; HEART failure; PROGNOSTIC models; ECHOCARDIOGRAPHY; VENTRICULAR ejection fraction; CHRONIC kidney failure; ATRIAL fibrillation
- Publication
Heart & Vessels, 2022, Vol 37, Issue 3, p451
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-021-01940-w