Background: The use of Cardiac Resynchronization Therapy (CRT) and Im-plantable Cardioverter Defibrillator (ICD) for Heart Failure (HF) is increasing. Re-nal dysfunction is a common condition associated with worse survival in patients with advanced HF. The study aims to elucidate the effect of renal function on survival in patients with heart failure. Methods: This was a multicenter study with a population consisted of 375 ad-vanced heart failure patients who received a CRT between 1999 and 2009, among these patients, 277 received also ICD implant. Clinical characteristics (NYHA functional class, ischemic vs non-ischemic aetiology, atrial fibrillation, di-abetes, Left Ventricular Ejection Fraction (LVEF), QRS duration and Glomerular Filtration Rate (eGFR) were recorded. The use of usual drugs was evaluated. Cox proportional hazards analysis was performed in order to identify variables associated with mortality. Results: During a median follow-up of 43.0 months, 93 patients died (24.8%). Patients deceased during the study had at baseline higher NYHA class and lower LVEF and eGFR. In Cox regression analysis eGFRis associated with mortality (Hazard Ratio (HR) relative to 10 mL/min/1.73 m2 increase = 0.80; 95% Con-fidence Interval (CI)=0.71-0.90; p0.001) independently by the effect of others covariates. In addition, a positive eGFR improvement 6 months after CRT implant is significantly associated with a lower hazard (for each 10 mL/min/1.73 m2 of eGFR improvement HR = 0.84 - 95% CI = 0.73-0.97; p=0.014). Conclusions: Low eGFR is associated with worst mortality in heart failure pa-tients who received CRT. Six months eGFR improvement is a marker independently associated with better survival.
|Titolo:||Renal function and mortality in patients with chronic heart failure treated with resynchronization therapy|
DONATELLI, FRANCESCO (Penultimo)
|Parole Chiave:||Heart Failure; Cardiac Resyncronization Therapy; Renal dysfunction|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||2013|
|Digital Object Identifier (DOI):||10.1093/eurheartj/eht309.P3157|
|Appare nelle tipologie:||01 - Articolo su periodico|