Long-term outcome of super-responder patients to cardiac resynchronization therapy

被引:40
|
作者
Zecchin, Massimo [1 ,2 ]
Proclemer, Alberto [1 ,2 ]
Magnani, Silvia [1 ,2 ]
Vitali-Serdoz, Laura [1 ,2 ]
Facchin, Domenico [3 ,4 ]
Muser, Daniele [3 ,4 ]
Nordio, Andrea [1 ,2 ]
Barbati, Giulia [1 ,2 ]
Puggia, Ilaria [1 ,2 ]
Sinagra, Gianfranco [1 ,2 ]
Proclemer, Alessandro [3 ,4 ]
机构
[1] Univ Trieste, Cardiovasc Dept, I-34129 Trieste, Italy
[2] Osped Riuniti Trieste Hosp, I-34129 Trieste, Italy
[3] Univ Udine, Cardiovasc Dept, I-33101 Udine, Italy
[4] Santa Maria della Misericordia Hosp, I-33101 Udine, Italy
来源
EUROPACE | 2014年 / 16卷 / 03期
关键词
Outcome; Super-responders; Cardiac resynchronization therapy; Heart failure; BUNDLE-BRANCH BLOCK; NONISCHEMIC DILATED CARDIOMYOPATHY; DEFIBRILLATOR IMPLANTATION TRIAL; HEART-FAILURE; MITRAL REGURGITATION; RECOMMENDATIONS; RESTORATION; PREDICTORS; PROGNOSIS; RECOVERY;
D O I
10.1093/europace/eut339
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To evaluate the long-term changes of clinical and echocardiographic parameters, the incidence of cardiac events and parameters associated with late cardiac events in super-responders to cardiac resynchronization therapy (CRT) with [CRT defibrillator (CRT-D)] or without defibrillator back-up. In all consecutive patients treated with CRT in two Italian centres (Trieste and Udine) with left ventricular ejection fraction (LVEF) 0.35 at implantation (T-imp) and LVEF 0.50 1 and/or 2 years (T-norm) after implantation, the long-term outcome and the evolution of echocardiographic parameters were assessed; factors associated with a higher risk of cardiac events, defined as hospitalization or death for heart failure (HF), sudden death, or CRT-D appropriate interventions, were also analysed. Among the 259 patients evaluated, 62 (24) had LVEF 0.50 at T-norm (n 44 with at 1 year, n 18 at 2 years). During a mean follow-up of 68 30 months, one cardiac death (for HF) and eight cardiovascular events (two hospitalization for HF and six appropriate CRT-D interventions) occurred. At the last echo evaluation (T-fup) performed 51 26 months after T-imp, LVEF was 0.50 in five patients (0.45 in four of them). At univariable analysis, only LV end-systolic volume evaluated at T-fup was associated with a higher risk of cardiac events during follow-up. In super-responders to CRT long-term outcome is excellent. However, cardiac events, mainly CRT-D appropriate interventions, can occur despite the persistence of LVEF 0.50. Early identification of these patients is still an unsolved issue.
引用
收藏
页码:363 / 371
页数:9
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