PMID- 21214589
OWN - NLM
STAT- MEDLINE
DCOM- 20110421
LR  - 20161125
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 34
IP  - 1
DP  - 2011 Jan
TI  - Female gender is associated with a better outcome after cardiac resynchronization 
      therapy.
PG  - 82-8
LID - 10.1111/j.1540-8159.2010.02909.x [doi]
AB  - BACKGROUND: Some studies have suggested that women respond differently to cardiac 
      resynchronization therapy (CRT). We sought to determine whether female gender 
      influences long-term clinical outcome, symptomatic response as well as 
      echocardiographic response after CRT. METHODS AND RESULTS: A total of 550 
      patients (age 70.4 +/- 10.7 yrs [mean +/- standard deviation]) were followed up for a 
      maximum of 9.1 years (median: 36.2 months) after CRT-pacing (CRT-P) or 
      CRT-defibrillation (CRT-D) device implantation. Outcome measure included 
      mortality as well as unplanned hospitalizations for heart failure or major 
      adverse cardiovascular events (MACE). Female gender predicted survival from 
      cardiovascular death (hazard ratio [HR]: 0.52, P = 0.0051), death from any cause 
      (HR: 0.52, P = 0.0022), the composite endpoints of cardiovascular death /heart 
      failure hospitalizations (HR: 0.56, P = 0.0036) and death from any 
      cause/hospitalizations for MACE (HR: 0.67, P = 0.0214). Female gender predicted 
      death from pump failure (HR: 0.55, P = 0.0330) but not sudden cardiac death. 
      Amongst the 322 patients with follow-up echocardiography, left ventricular (LV) 
      reverse remodelling (>/= 15% reduction in LV end-systolic volume) was more 
      pronounced in women (62% vs 44%, P = 0.0051). In multivariable Cox proportional 
      hazards analyses, the association between female gender and cardiovascular 
      survival was independent of age, LV ejection fraction, atrial rhythm, QRS 
      duration, CRT device type, New York Heart Association (NYHA) class, and LV 
      reverse remodelling (adjusted HR: 0.48, P = 0.0086). At one year, the symptomatic 
      response rate (improvement by >/= 1 NYHA classes or >/= 25% increase in walking 
      distance) was 78% for both women and men. CONCLUSIONS: Female gender is 
      independently associated with a lower mortality and morbidity after CRT.
CI  - (c)2010, The Authors. Journal compilation (c)2010 Wiley Periodicals, Inc.
FAU - Leyva, Francisco
AU  - Leyva F
AD  - Center for Cardiovascular Sciences, Queen Elizabeth Hospital, University of 
      Birmingham, Birmingham, UK. cardiologists@hotmail.com
FAU - Foley, Paul W X
AU  - Foley PW
FAU - Chalil, Shajil
AU  - Chalil S
FAU - Irwin, Nick
AU  - Irwin N
FAU - Smith, Russell E A
AU  - Smith RE
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100923
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy/*mortality
MH  - Female
MH  - Heart Failure/*mortality/*prevention & control
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sex Distribution
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
MH  - United Kingdom/epidemiology
EDAT- 2011/01/11 06:00
MHDA- 2011/04/22 06:00
CRDT- 2011/01/11 06:00
PHST- 2011/01/11 06:00 [entrez]
PHST- 2011/01/11 06:00 [pubmed]
PHST- 2011/04/22 06:00 [medline]
AID - 10.1111/j.1540-8159.2010.02909.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2011 Jan;34(1):82-8. doi: 
      10.1111/j.1540-8159.2010.02909.x. Epub 2010 Sep 23.