کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5972384 | 1576192 | 2014 | 8 صفحه PDF | دانلود رایگان |
BackgroundReverse remodeling and increased LVEF after CRT correlate with survival and heart failure hospitalizations, but their relationship with the risk of SCD is unclear. We aimed to evaluate whether exceeding a threshold value of 35% for left ventricular ejection fraction (LVEF) 1 year after cardiac resynchronization therapy (CRT) predicts survival and freedom from sudden cardiac death (SCD).Methods330 patients who survived â¥Â 6 months after CRT (males 80%, age 62 ± 11 years) were grouped according to 1-year LVEF â¤Â 35% (Group 1, n = 187, 57%) or > 35% (Group 2, n = 143, 43%). According to changes vs. baseline (reduction of left end-systolic volume [LVESV] â¥Â 10% or increase of LVEF% > 10 units), patients were also classified as echocardiographic (Echo) non-responders (Group A, n = 152, 46%) or responders (Group B, n = 178, 54%).ResultsAt baseline, LVESV volume was larger and LVEF was lower in Group 1 vs. Group 2 (p < 0.001). After 1 year, echocardiographic improvement was greater in Group 2 vs. Group 1 (p < 0.001 for changes in both LVESV and LVEF). Over a median follow-up of 49 months, 47 patients (14%) died, 36 in Group 1 vs. 11 in Group 2 (19% vs. 8%, p = 0.004). A significantly higher rate of freedom from all-cause mortality (p = 0.002), cardiovascular mortality (p < 0.001) and SCD (p < 0.001) was observed in Group 2. Multivariate analysis demonstrated that only 1-year LVEF > 35% was associated with freedom from SCD/VF.ConclusionsLVEF > 35% after 1 year of CRT characterizes a favorable long-term outcome, with a very low risk for SCD.
Journal: International Journal of Cardiology - Volume 172, Issue 1, 1 March 2014, Pages 64-71