BACKGROUND: Cardiac resynchronization therapy (CRT) improves symptoms, left ventricular ejection fraction (LVEF) and survival in patients with heart failure and wide QRS, however, long term clinical outcome is unknown. AIMS: To identify predictors of mortality and evaluate the effects of CRT after long term follow-up. METHODS: Consecutive patients treated with CRT between 1997 and 2002 were included. We collected clinical information from patient files. Patients who were still alive underwent echocardiography and clinical evaluation. RESULTS: We included 179 patients (median age 65.5 years, 144 male). Median follow-up for survival was 4.0 years. Mortality at one and five years was 15% and 53%, respectively. Predictors of mortality were, ischaemic heart disease (IHD), higher NYHA class and lower LVEF (<22.5%) at baseline, and no improvement in NYHA class at early follow-up. NYHA class remained stable from early to long term follow-up after a median of 5.1 years. In patients with non-IHD median LVEF increased significantly from early to long term follow-up (39% vs. 50% p=0.007). CONCLUSION: Predictors of mortality in patients with CRT are IHD, lower LVEF and higher NYHA class at baseline, and no symptomatic response to CRT. After 5 years follow-up, clinical effects are sustained, and in patients with non-IHD further improvements in LVEF are observed.
BACKGROUND: Cardiac resynchronization therapy (CRT) improves symptoms, left ventricular ejection fraction (LVEF) and survival in patients with heart failure and wide QRS, however, long term clinical outcome is unknown. AIMS: To identify predictors of mortality and evaluate the effects of CRT after long term follow-up. METHODS: Consecutive patients treated with CRT between 1997 and 2002 were included. We collected clinical information from patient files. Patients who were still alive underwent echocardiography and clinical evaluation. RESULTS: We included 179 patients (median age 65.5 years, 144 male). Median follow-up for survival was 4.0 years. Mortality at one and five years was 15% and 53%, respectively. Predictors of mortality were, ischaemic heart disease (IHD), higher NYHA class and lower LVEF (<22.5%) at baseline, and no improvement in NYHA class at early follow-up. NYHA class remained stable from early to long term follow-up after a median of 5.1 years. In patients with non-IHD median LVEF increased significantly from early to long term follow-up (39% vs. 50% p=0.007). CONCLUSION: Predictors of mortality in patients with CRT are IHD, lower LVEF and higher NYHA class at baseline, and no symptomatic response to CRT. After 5 years follow-up, clinical effects are sustained, and in patients with non-IHD further improvements in LVEF are observed.
Authors: Eduardo Arrais Rocha; Francisca Tatiana Moreira Pereira; José Sebastião Abreu; José Wellington O Lima; Marcelo de Paula M Monteiro; Almino Cavalcante Rocha Neto; Ana Rosa Pinto Quidute; Camilla Viana A Goés; Carlos Roberto Martins Rodrigues Sobrinho; Maurício Ibrahim Scanavacca Journal: Arq Bras Cardiol Date: 2015-09-04 Impact factor: 2.000
Authors: Malek Khatib; José M Tolosana; Emilce Trucco; Roger Borràs; Angeles Castel; Antonio Berruezo; Adelina Doltra; Marta Sitges; Elena Arbelo; Maria Matas; Josep Brugada; Lluís Mont Journal: Eur J Heart Fail Date: 2014-05-23 Impact factor: 15.534
Authors: Eduardo Arrais Rocha; Francisca Tatiana Moreira Pereira; José Sebastião Abreu; José Wellington O Lima; Marcelo de Paula Martins Monteiro; Almino Cavalcante Rocha Neto; Camilla Viana Arrais Goés; Ana Gardênia P Farias; Carlos Roberto Martins Rodrigues Sobrinho; Ana Rosa Pinto Quidute; Maurício Ibrahim Scanavacca Journal: Arq Bras Cardiol Date: 2015-08-07 Impact factor: 2.000