Cardiac resynchronisation therapy: Evidence based benefits and patient selection

Albouaini, Khaled; Egred, Mohaned; Rao, Archana; Alahmar, Albert; Wright, David J.

doi:10.1016/j.ejim.2007.09.012

Cited by 22 publications

(17 citation statements)

References 37 publications

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“…Importantly, improvement in GFR showed a trend towards decreased mortality during long term follow up. The mechanism of improvement in LV function, symptoms and survival is probably due to synchronized stimulation of both right and left ventricles to contract simultaneously and thereby correcting atrioventricular mechanical dyssynchrony, atrioventricular interval, interventricular conduction delay and improving left ventricular (LV) contractility [19], [20], [21], [22], [23]. Recent studies have shown that patients who have pre-renal azotemia (probably reflecting patients with cardio-renal syndrome) showed decreased risk of death or heart failure compared to patients with a low BUN/Cr ratio [15].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Resynchronization Therapy prevents progression of renal failure in heart failure patients

Jeevanantham

Turagam

Shanberg

et al. 2016

Indian Pacing and Electrophysiology Journal

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BackgroundThe goal of this study is to assess the effect of cardiac resynchronization therapy (CRT) over time on renal function and its impact on mortality. The effect of CRT on renal function in patients with heart failure is not well understood.MethodsAll patients who underwent CRT implantation at University of Kansas between year 2000 and 2009 were reviewed and patients who had pre and post CRT renal function studied were included in our study. Stages of chronic kidney disease (CKD) were defined based on Kidney Disease Outcome Quality Initiative (KDOQI) guidelines. The effect of CRT on renal and cardiac function were studied at short term (≤6 months post implantation) and long term (>6 months).ResultsA total of 588 patients with mean age of 67 ± 12 yrs were included in the study. CRT responders (defined by increase in LVEF ≥ 5%) were 54% during short term follow-up and 65% on long term follow-up. When compared to baseline, there was no significant deterioration in mean Glomerular Filtration Rate (GFR) during follow up. When analyzed based on the stages of CKD, there was significant improvement of renal function in patients with advanced kidney disease. Multivariate logistic regression analysis showed that stable GFR or an improvement in GFR independently predicted mortality after adjusting for co-morbidities.ConclusionsCRT was associated with stabilization of renal function in patients with severe LV dysfunction and improvement in stage 4 and 5 CKD. Improved renal function was associated with a lower mortality.

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Section: Discussionmentioning

confidence: 99%

Cardiac Resynchronization Therapy prevents progression of renal failure in heart failure patients

Jeevanantham

Turagam

Shanberg

et al. 2016

Indian Pacing and Electrophysiology Journal

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“…Hence, mechanical support under the form of destination therapy has made substantial improvements that translate into better outcomes of patients who are not eligible for transplantation (Slaughter et al , 2011) but it requires strict inclusion criteria. Cardiac resynchronization still fails in 20-30% of patients (Albouaini et al , 2008). The early results of gene therapy targeting calcium handling have been encouraging but need to be confi rmed (Jessup et al , 2011).…”

Section: Rationale For Using Embryonic Stem Cells (Escs) To Treat Sevmentioning

confidence: 99%

Human embryonic stem cells (hESCs) for heart regeneration

Menasché

2014

Cardiac Regeneration and Repair

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“…No large studies have evaluated this approach. Figure 210 shows a chest x-ray of a patient with a biventricular pacemaker with a pacing lead positioned in the target vein (posterolateral veins).…”

Section: Crt Implantation Techniquementioning

confidence: 99%

Cardiac resynchronisation therapy: what a hospital practitioner needs to know?

Albouaini

Alkarmi²,

Wright³

2010

Postgraduate Medical Journal

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The incidence and prevalence of heart failure are rapidly rising. Despite the improvement in pharmacologic treatment, many patients have severe persistent symptoms, and their prognosis remains poor. One of the most recent advances in heart failure management is the concept of cardiac resynchronisation therapy (CRT). This therapy aims to pace the right and left ventricles synchronously to contract simultaneously and therefore enhances cardiac output. Clinical trials on CRT have demonstrated both morbidity and mortality benefits. This article reviews the evidence for CRT, the current indications, and important information relevant to the clinician treating patients with heart failure. It also highlights some of the current controversies in this field as well as the need for future research.

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Cardiac resynchronisation therapy: Evidence based benefits and patient selection

Cited by 22 publications

References 37 publications

Cardiac Resynchronization Therapy prevents progression of renal failure in heart failure patients

Cardiac Resynchronization Therapy prevents progression of renal failure in heart failure patients

Human embryonic stem cells (hESCs) for heart regeneration

Cardiac resynchronisation therapy: what a hospital practitioner needs to know?

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