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Open AccessArticle

Prognostication of Poor Survival After Cardiac Resynchronization Therapy

1
Department of Cardiology, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania
2
Kaunas Region Society of Cardiology, Kaunas 50009, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(1), 19; https://doi.org/10.3390/medicina56010019
Received: 11 November 2019 / Revised: 1 December 2019 / Accepted: 31 December 2019 / Published: 4 January 2020
Background and Objectives: Cardiac resynchronization therapy (CRT) is a successful treatment option for appropriately selected patients. However, one–third of recipients do not experience any positive outcome or their condition even declines. We aimed to assess preimplantation factors associated with worse survival after the CRT. Materials and Methods: This was a retrospective unicenter trial. The study cohort included 183 consecutive CRT-treated patients. Baseline demographic, clinical, electrocardiographic, and echocardiographic characteristics were analyzed. Results: After the median follow-up of 15.6 months (9.3–26.3), 20 patients had died (11%). In multivariate Cox regression analysis, ischemic origin of heart failure (HF) was a significant predictor of poor survival (adjusted hazard ratio (aHR) 15.235, 95% confidence interval (CI) (1.999–116.1), p = 0.009). In univariate Cox regression, tricuspid annular plane systolic excursion (TAPSE) <15.5 mm (sensitivity 0.824, specificity 0.526; HR 5.019, 95% CI (1.436–17.539), p = 0.012), post-implantation prescribed antiplatelet agents (HR 2.569, 95% CI (1.060–6.226), p = 0.037), statins (HR 2.983, 95% CI (1.146–7.764), p = 0.025), and nitrates (HR 3.694, 95% CI (1.342–10.171), p = 0.011) appeared to be related with adverse outcome. Conclusions: ischemic etiology of HF is a significant factor associated with worse survival after the CRT. Decreased TAPSE is also related to poor survival. View Full-Text
Keywords: heart failure; cardiac resynchronization therapy; biventricular pacing; ischemic cardiomyopathy; pulmonary hypertension; echocardiography heart failure; cardiac resynchronization therapy; biventricular pacing; ischemic cardiomyopathy; pulmonary hypertension; echocardiography
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Bašinskas, P.; Stoškutė, N.; Gerulytė, A.; Abramavičiūtė, A.; Puodžiukynas, A.; Kazakevičius, T. Prognostication of Poor Survival After Cardiac Resynchronization Therapy. Medicina 2020, 56, 19.

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