Publication
What Happens to Non-Responders in Cardiac Resynchronization Therapy?
| dc.contributor.author | Rio, P | |
| dc.contributor.author | Oliveira, MM | |
| dc.contributor.author | Cunha, PS | |
| dc.contributor.author | Nogueira da Silva, M | |
| dc.contributor.author | Branco, LM | |
| dc.contributor.author | Galrinho, A | |
| dc.contributor.author | Soares, R | |
| dc.contributor.author | Feliciano, J | |
| dc.contributor.author | Pimenta, R | |
| dc.contributor.author | Cruz Ferreira, R | |
| dc.date.accessioned | 2018-01-09T15:53:45Z | |
| dc.date.available | 2018-01-09T15:53:45Z | |
| dc.date.issued | 2017-12 | |
| dc.description.abstract | INTRODUCTION AND OBJECTIVES: Left ventricular reverse remodeling (LVRR) is strongly related to the long-term prognosis of patients undergoing cardiac resynchronization therapy (CRT). The aim of this study was to assess the long-term clinical outcome of patients without LVRR at six months after CRT implantation and to determine the prognostic impact of clinical response in this population. METHODS: We analyzed 178 consecutive patients who underwent successful CRT device implantation (age 64±11 years; 69% male; 89% in New York Heart Association [NYHA] functional class III; 35% with ischemic cardiomyopathy). Clinical status and echocardiographic parameters were determined before and six months after CRT implantation. We identified those without criteria for LVRR (≥10% increase in left ventricular ejection fraction with ≥15% reduction in left ventricular end-systolic diameter compared to baseline). Clinical responders were defined by a sustained improvement of at least one NYHA functional class. RESULTS: At six-month assessment after CRT, 109 (61%) patients showed LVRR. During a mean follow-up of 56±21 months, 47 (26%) patients died, with higher mortality in the group without LVRR (36% vs. 20%, p=0.023). Clinical response was greater in patients with LVRR (88% vs. 55%, p<0.001). In patients without LVRR, clinical response to CRT was the strongest independent predictor of survival (hazard ratio: 0.120; 95% confidence interval: 0.039-0.366; p<0.001). CONCLUSION: Although patients without LVRR six months after CRT implantation had a worse prognosis, with higher all-cause mortality, clinical response can be an independent predictor of survival in this population. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Rev Port Cardiol. 2017 Dec;36(12):885-892 | pt_PT |
| dc.identifier.doi | 10.1016/j.repc.2017.02.017 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/2839 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier España | pt_PT |
| dc.subject | HSM CAR | pt_PT |
| dc.subject | Cardiac Resynchronization Therapy | pt_PT |
| dc.subject | Defibrillators, Implantable | pt_PT |
| dc.subject | Heart Failure/therapy | pt_PT |
| dc.subject | Retrospective Studies | pt_PT |
| dc.subject | Time Factors | |
| dc.subject | Treatment Failure | |
| dc.title | What Happens to Non-Responders in Cardiac Resynchronization Therapy? | pt_PT |
| dc.title.alternative | O Que Acontece aos Não Respondedores na Terapia de Ressincronização Cardíaca? | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 892 | pt_PT |
| oaire.citation.issue | 12 | pt_PT |
| oaire.citation.startPage | 885 | pt_PT |
| oaire.citation.title | Revista Portuguesa de Cardiologia (English Edition) | pt_PT |
| oaire.citation.volume | 36 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |