Relationship between pre-implant ejection fraction and outcome after cardiac resynchronization therapy in symptomatic patients
| Autor: | Carmine Muto, Themistoklis Maounis, Luigi Padeletti, Andreas Schuchert, Alexander Polauck, Rita Omega Ella |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pacemaker Artificial medicine.medical_specialty medicine.medical_treatment Cardiac resynchronization therapy Thigh Nyha class Cardiac Resynchronization Therapy Germany Internal medicine medicine Humans Single-Blind Method cardiovascular diseases Aged Ultrasonography Heart Failure Ejection fraction Greece business.industry Follow up studies Stroke Volume General Medicine Stroke volume Middle Aged medicine.disease humanities Defibrillators Implantable Treatment Outcome medicine.anatomical_structure Italy Heart failure cardiovascular system Cardiology Female France Implant Cardiology and Cardiovascular Medicine business Follow-Up Studies circulatory and respiratory physiology |
| Zdroj: | Acta Cardiologica. 69:424-432 |
| ISSN: | 0373-7934 0001-5385 |
| DOI: | 10.1080/ac.69.4.3036659 |
| Popis: | Left-ventricular ejection fraction (LVEF) is regarded as a strong predictor for morbidity and mortality in heart failure patients. The aim of the analysis was to assess the relationship between pre-implant LVEF and outcome of patients with advanced heart failure who received cardiac resynchronization therapy (CRT).We analysed the two-year follow-up of 366 patients who had been enrolled in the MASCOT study which included NYHA class III/IV patients with a class I CRT indication. Pre-implant LVEF was stratified by tertile.The boundaries for pre-implant LVEF were22% (n = 128; 18.2 +/- 3.1%; T(low)), 22% to 28% (n = 121; 25.4 +/- 1.4%; T(middle)) and28% (n = 117; 32.6 +/- 3.9%; T(high)) for each tertile.Two-year post-implant LVEF was 32.0 +/- 11.5% (T(low)), 33.7 +/- 10.8% (T(middle)) and 36.4 +/- 9.9% (T(high)). T(Iow) had a greater increase between pre- and post-implant LVEF compared to T(middle) (P = 0.03) and T(high) (P = 0.0001). NYHA class improved similarly among the three groups as well as the quality of life score. No significant differences were detected between the three groups for all-cause mortality, cardiac death, all-cause hospitalization, and hospitalization due to worsening heart failure.Symptomatic heart failure patients with a wide QRS complex and a severe impaired LV function had a better improvement of their pre-implant LVEF than patients with a more preserved LVEF. This may be one reason that in these patient groups long-term morbidity and mortality were not related to their pre-implant LVEF. Pre-implant LVEF was in symptomatic CRT patients not predictive for their long-term cardiovascular morbidity and mortality. |
| Databáze: | OpenAIRE |
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