Functional response to cardiac resynchronization therapy in patients with renal dysfunction and subsequent long-term mortality.
J Cardiovasc Electrophysiol
; 25(11): 1188-95, 2014 Nov.
Article
em En
| MEDLINE
| ID: mdl-24891182
ABSTRACT
INTRODUCTION:
Renal dysfunction is associated with increased morbi-mortality in heart failure patients. Data regarding functional and clinical efficacy of cardiac resynchronization therapy (CRT) in this population are limited. METHODS ANDRESULTS:
We aimed to evaluate the rate of functional response to CRT in patients with renal dysfunction and its association with long-term mortality. Our study included a total of 179 consecutive patients implanted between 2007 and 2010. The rate of functional response to CRT (defined by a composite score using New York Heart Association functional class, 6-minute walk test, and quality of life) was compared between patients with and without renal dysfunction (defined as eGFR < or ≥60 mL/min/1.73 m(2) ). Survival analysis estimates were constructed according to the Kaplan-Meier method, with results comparison using the log-rank test. During a median follow-up of 4.2 years, 73 patients (40%) died. Patients with low eGFR were older (72 ± 8 years vs. 64 ± 12 years; P < 0.001), and had higher prevalence of ischemic heart disease (75% vs. 53%; P = 0.003). Functional response rates did not differ significantly between patients with and without renal dysfunction (58% and 69%, respectively; P = 0.14). Despite overall higher mortality in patients with low eGFR (53.8% vs. 22.7%; P < 0.001), the presence of functional response at 1 year among patients with renal dysfunction was still independently associated with an improved long-term survival (HR = 0.49 [95%CI 0.28-0.83]; P = 0.009).CONCLUSION:
Functional response to CRT at 1 year does not differ significantly between patients with or without kidney disease, and is an independent predictor of improved long-term survival in patients with renal dysfunction.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Terapia de Ressincronização Cardíaca
/
Insuficiência Cardíaca
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Nefropatias
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article