Predictors of long-term mortality with cardiac resynchronization therapy in mild heart failure patients with left bundle branch block

Clinical Cardiology
Yitschak BitonValentina Kutyifa

Abstract

Cardiac resynchronization therapy (CRT) is highly beneficial in patients with heart failure (HF) and left bundle branch block (LBBB); however, up to 30% of patients in this selected group are nonresponders. We hypothesized that clinical and echocardiographic variables can be used to develop a simple mortality risk stratification score in CRT. Best-subsets proportional-hazards regression analysis was used to develop a simple clinical risk score for all-cause mortality in 756 patients with LBBB allocated to the CRT with defibrillator (CRT-D) group enrolled in the multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy. The score was used to assess the mortality risk within the CRT-D group and the associations with mortality reduction with CRT-D vs implantable cardioverter defibrillator (ICD) in each risk category. Four clinical variables comprised the risk score: age ≥ 65, creatinine ≥ 1.4 mg/dL, history of coronary artery bypass graft, and left ventricular ejection fraction (LVEF) < 26%. Every 1 point increase in the score was associated with 2-fold increased mortality within the CRT-D arm (P < 0.001). CRT-D was associated with mortality reduction as compared with ICD only in patients with m...Continue Reading

References

Mar 1, 1982·Circulation·L E Hinkle, H T Thaler
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
May 21, 2004·The New England Journal of Medicine·Alan KadishUNKNOWN Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators
Mar 9, 2005·The New England Journal of Medicine·John G F ClelandUNKNOWN Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators
Nov 9, 2005·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Arthur J MossWojciech Zareba
Nov 29, 2008·Journal of the American College of Cardiology·Cecilia LindeUNKNOWN REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) Study Group
Sep 3, 2009·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-CRT Trial Investigators
May 8, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Evgeny PokushalovAlexander Karaskov
Nov 16, 2010·The New England Journal of Medicine·Anthony S L TangUNKNOWN Resynchronization-Defibrillation for Ambulatory Heart Failure Trial Investigators
Sep 7, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Daniel B KramerRobert G Hauser
Jul 17, 2012·Journal of the American College of Cardiology·Matthias DupontW H Wilson Tang
Nov 1, 2012·European Journal of Heart Failure·François RegoliUNKNOWN collaborative study group
Apr 1, 2014·The New England Journal of Medicine·Ilan GoldenbergArthur J Moss
Aug 30, 2014·Journal of the American College of Cardiology·Robbert ZusterzeelDavid G Strauss
Jan 1, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alexander RomanovEvgeny Pokushalov
Jul 20, 2016·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Krishna KancharlaAnthon R Fuisz
Jan 21, 2017·Journal of the American College of Cardiology·Jarrod K BetzFrederick A Masoudi

❮ Previous
Next ❯

Citations

Sep 19, 2020·ESC Heart Failure·Jiří KvasničkaEva Čermáková

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.

Related Papers

© 2022 Meta ULC. All rights reserved