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The Arterial Baroreflex Effectiveness Index in Risk Stratification of Chronic Heart Failure Patients Who Are Candidates for Cardiac Resynchronization Therapy

2016-06Journal article Open access
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dc.contributor.authorSerôdio, JF
dc.contributor.authorOliveira, MM
dc.contributor.authorLaranjo, S
dc.contributor.authorTavares, C
dc.contributor.authorCunha, PS
dc.contributor.authorAbreu, A
dc.contributor.authorBranco, LM
dc.contributor.authorAlves, S
dc.contributor.authorRocha, I
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2018-08-06T14:43:32Z
dc.date.available2018-08-06T14:43:32Z
dc.date.issued2016-06
dc.description.abstractINTRODUCTION: Baroreflex function is an independent marker of prognosis in heart failure (HF). However, little is known about its relation to response to cardiac resynchronization therapy (CRT). The aim of this study is to assess arterial baroreflex function in HF patients who are candidates for CRT. METHODS: The study population consisted of 25 patients with indication for CRT, aged 65±10 years, NYHA functional class ≥III in 52%, QRS width 159±15 ms, left ventricular ejection fraction (LVEF) 29±5%, left ventricular end-systolic volume (LVESV) 150±48 ml, B-type natriuretic peptide (BNP) 357±270 pg/ml, and peak oxygen consumption (peak VO2) 18.4±5.0 ml/kg/min. An orthostatic tilt test was performed to assess the baroreflex effectiveness index (BEI) by the sequence method. This group was compared with 15 age-matched healthy individuals. RESULTS: HF patients showed a significantly depressed BEI during tilt (31±12% vs. 49±18%, p=0.001). A lower BEI was associated with higher BNP (p=0.038), lower peak VO2 (p=0.048), and higher LVESV (p=0.031). By applying a cut-off value of 25% for BEI, two clusters of patients were identified: lower risk cluster (BEI >25%) QRS 153 ms, LVESV 129 ml, BNP 146 pg/ml, peak VO2 19.0 ml/kg/min; and higher risk cluster (IEB ≤25%) QRS 167 ms, LVESV 189 ml, BNP 590 pg/ml, peak VO2 16.2 ml/kg/min. CONCLUSIONS: Candidates for CRT show depressed arterial baroreflex function. Lower BEI was observed in high-risk HF patients. Baroreflex function correlated closely with other clinical HF parameters. Therefore, BEI may improve risk stratification in HF patients undergoing CRT.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2016 Jun;35(6):343-50.pt_PT
dc.identifier.doi10.1016/j.repc.2015.11.021pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3009
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectHeart Failurept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectNatriuretic Peptide, Brainpt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectStroke Volumept_PT
dc.subjectTreatment Outcomept_PT
dc.subjectBaroreflexpt_PT
dc.subjectCardiac Resynchronization Therapypt_PT
dc.subjectHSM CARpt_PT
dc.titleThe Arterial Baroreflex Effectiveness Index in Risk Stratification of Chronic Heart Failure Patients Who Are Candidates for Cardiac Resynchronization Therapypt_PT
dc.title.alternativeO Índice de Eficácia do Barorreflexo na Estratificação de Risco de Doentes com Insuficiência Cardíaca Crónica Candidatos à Terapêutica de Ressincronização Cardíacapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage350pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage343pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume35pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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