Etiologic impact on difference on clinical outcomes of patients with heart failure after cardiac resynchronization therapy

Chen, Jianshu; Niu, Xiaowei; Chen, Fen-Mei; Yao, Yali

doi:10.1097/md.0000000000013725

Cited by 6 publications

(3 citation statements)

References 47 publications

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“…A previous systematic review on this topic showed that NICM, LBBB, longer QRS, and female gender are associated with improvement in various outcomes after CRT. [21] In consonance with previous studies, [22] , [23] , [24] , [25] the present meta -analysis confirmed, with data from real-world, the importance of these clinical variables to achieve the desired left ventricular reverse remodeling with CRT.…”

Section: Discussionsupporting

confidence: 90%

Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-Analysis

Martins

António

Donato

et al. 2022

IJC Heart & Vasculature

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Section: Discussionsupporting

confidence: 90%

Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-Analysis

Martins

António

Donato

et al. 2022

IJC Heart & Vasculature

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“…In contrast, in the NICM patients who experienced ADHF, it may be related to weakness and fatigue of cardiomyocytes. The different response between ICM and NICM were also noted in HF patients with sacubitril/valsartan treatment or cardiac resynchronization therapy and provided better response of LV remodeling in the NICM population [ 28 , 29 , 30 , 31 ]. However, the mechanism was not well explored, and our results also presented that levosimendan had a different effect on mortality between the ICM and NICM populations.…”

Section: Discussionmentioning

confidence: 99%

Levosimendan Administration May Provide More Benefit for Survival in Patients with Non-Ischemic Cardiomyopathy Experiencing Acute Decompensated Heart Failure

Lee

Fang

et al. 2022

JCM

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Background: Acute decompensated heart failure (ADHF) is a life-threatening condition with a high mortality rate. Levosimendan is an effective inotropic agent used to maintain cardiac output and a long-lasting effect. However, only few studies have compared the clinical outcomes, after levosimendan therapy, among etiologies of ADHF. Methods: Between July 2014 and December 2019, 184 patients received levosimendan therapy for ADHF at our hospital. A total of 143 patients had ischemic cardiomyopathy (ICM), and 41 patients had non-ICM (NICM). Data on comorbidities, echocardiographic findings, laboratory findings, use of mechanical devices, consumption of other inotropic or vasopressor agents, frequency of HF hospitalization, cardiovascular (CV) mortality, and all-cause mortality were compared between the ICM and NICM groups. Results: Patients with ICM were older with higher prevalence of diabetes mellitus when compared to patients with NICM. Patients with NICM had a poorer left ventricular ejection fraction (LVEF) and higher left ventricular end-systolic volume when compared to patients with ICM. At the 30 day follow-up period, a lower CV mortality (ICM vs. NICM: 20.9% vs. 5.1%; log-rank p = 0.033) and lower all-cause mortality (ICM vs. NICM: 28.7% vs. 9.8%; log-rank p = 0.018) was observed in the NICM patients. A significantly lower all-cause mortality was noted at 180 day (ICM vs. NICM: 39.2% vs. 22.0%; log-rank p = 0.043) and 1 year (ICM vs. NICM: 41.3% vs. 24.4%; log-rank p = 0.046) follow up in the NICM subgroup. NICM (hazard ratio (HR): 0.303, 95% confidence interval (CI): 0.108–0.845; p = 0.023) and ECMO use (HR: 2.550, 95% CI: 1.385–4.693; p = 0.003) were significant predictors of 30 day all-cause mortality. Conclusions: In our study on levosimendan use for ADHF patients, better clinical outcomes were noted in the NICM population when compared to the ICM population. In the patients with cardiogenic shock or ventilator use, significantly lower incidence of 30 day mortality presented in the NICM population when compared with the ICM population.

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“…The most recent clinical trials led by Francisco [5] and Jian-Shu [34] found that ischemic cardiomyopathy is a significant predictor related to worse survival after the CRT. The underlying mechanism of this phenomenon could be explained by CRT correcting conduction disorders caused by delayed activation regions of the left ventricular wall.…”

Section: Discussionmentioning

confidence: 99%

Prognostication of Poor Survival After Cardiac Resynchronization Therapy

et al. 2020

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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.

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Etiologic impact on difference on clinical outcomes of patients with heart failure after cardiac resynchronization therapy

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 47 publications

Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-Analysis

Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-Analysis

Levosimendan Administration May Provide More Benefit for Survival in Patients with Non-Ischemic Cardiomyopathy Experiencing Acute Decompensated Heart Failure

Prognostication of Poor Survival After Cardiac Resynchronization Therapy

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