PMID- 18371486
OWN - NLM
STAT- MEDLINE
DCOM- 20080418
LR  - 20161124
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 155
IP  - 4
DP  - 2008 Apr
TI  - Clinical response of cardiac resynchronization therapy in the elderly.
PG  - 746-51
LID - 10.1016/j.ahj.2007.11.009 [doi]
AB  - BACKGROUND: Although prevalence of heart failure increases with age, in most 
      clinical trials of cardiac resynchronization therapy (CRT), older patients are 
      not included. Observational studies of effects of CRT in older patients had a 
      small sample size. In the present study, the clinical and echocardiographic 
      response to CRT in a larger group of elderly (age > 75 years) patients was 
      evaluated. METHODS: In this prospective observational study of 266 consecutive 
      patients, CRT was performed in 107 elderly patients (40%) and 159 (60%) younger 
      patients (age < or = 75 years). Echocardiographic and clinical parameters were 
      evaluated at baseline and at 3, 12, and 24 months. RESULTS: In the elderly group, 
      mean age was 79 years compared with 67 years in patients aged < or = 75 years. 
      Clinical baseline characteristics between the 2 groups were comparable. During 
      follow-up, there was a comparable and sustained improvement in both groups 
      according to New York Heart Association (NYHA) class, quality of life score, and 
      left ventricular (LV) ejection fraction. Clinical response, defined as survival 
      with improvement (> or = 1 score) of NYHA class without hospital admittance for 
      heart failure, was seen in 67% and 69% (group aged < or = 75 years) versus 65% 
      and 60% (group aged > 75 years) after 3 months and 1 year, respectively. Reverse 
      LV remodeling defined as LV end-systolic volume reduction > or = 10% was seen in 
      79% and 87% (group aged < or = 75 years) versus 71% and 79% (group aged > 75 
      years) after 3 months and 1 year, respectively. Hospitalization for heart failure 
      decreased significantly in both groups in the year after CRT. A subgroup analysis 
      of 39 octogenarians (> 80 years) also showed a significant improvement in NYHA 
      class and LV ejection fraction in this subgroup. Also, LV reverse remodeling 
      occurred in a similar extent (75% and 84%) after 3 months and 1 year, 
      respectively. CONCLUSIONS: This study shows a clinical and echocardiographic 
      improvement of CRT in patients aged > 75 years and even so in octogenarians.
FAU - Delnoy, Peter Paul H M
AU  - Delnoy PP
AD  - Isala klinieken, Utrecht University, Zwolle, The Netherlands. 
      v.r.c.derks@isala.nl
FAU - Ottervanger, Jan Paul
AU  - Ottervanger JP
FAU - Luttikhuis, Henk Oude
AU  - Luttikhuis HO
FAU - Elvan, Arif
AU  - Elvan A
FAU - Misier, Anand R Ramdat
AU  - Misier AR
FAU - Beukema, Willem P
AU  - Beukema WP
FAU - van Hemel, Norbert M
AU  - van Hemel NM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20080221
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cardiac Pacing, Artificial
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Failure/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Observation
MH  - Prospective Studies
MH  - Quality of Life
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Remodeling
EDAT- 2008/03/29 09:00
MHDA- 2008/04/19 09:00
CRDT- 2008/03/29 09:00
PHST- 2007/04/19 00:00 [received]
PHST- 2007/11/09 00:00 [accepted]
PHST- 2008/03/29 09:00 [pubmed]
PHST- 2008/04/19 09:00 [medline]
PHST- 2008/03/29 09:00 [entrez]
AID - S0002-8703(07)00916-7 [pii]
AID - 10.1016/j.ahj.2007.11.009 [doi]
PST - ppublish
SO  - Am Heart J. 2008 Apr;155(4):746-51. doi: 10.1016/j.ahj.2007.11.009. Epub 2008 Feb 
      21.