PMID- 23141857
OWN - NLM
STAT- MEDLINE
DCOM- 20130823
LR  - 20121112
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 18
IP  - 11
DP  - 2012 Nov
TI  - Comorbidity significantly affects clinical outcome after cardiac 
      resynchronization therapy regardless of ventricular remodeling.
PG  - 845-53
LID - S1071-9164(12)01265-1 [pii]
LID - 10.1016/j.cardfail.2012.09.003 [doi]
AB  - BACKGROUND: The influence of comorbid conditions on ventricular remodeling, 
      functional status, and clinical outcome after cardiac resynchronization therapy 
      (CRT) is insufficiently elucidated. METHODS AND RESULTS: The influence of 
      different comorbid conditions on left ventricular remodeling, improvement in New 
      York Heart Association (NYHA) functional class, hospitalizations for heart 
      failure, and all-cause mortality after CRT implantation was analyzed in 172 
      consecutive patients (mean age 71 +/- 9 y), implanted from October 2008 to April 
      2011 in a single tertiary care hospital. During mean follow-up of 18 +/- 9 months, 
      21 patients died and 57 were admitted for heart failure. Left ventricular 
      remodeling and improvement in NYHA functional class were independent from 
      comorbidity burden. However, diabetes mellitus (hazard ratio [HR] 3.45, 95% 
      confidence interval [CI] 1.24-9.65) and chronic kidney disease (HR 3.11, 95% CI 
      1.10-8.81) were predictors of all-cause mortality, and the presence of chronic 
      obstructive pulmonary disease (HR 1.89, 95% CI 1.02-3.53) was independently 
      associated with heart failure admissions. Importantly, those 3 comorbid 
      conditions had an additive negative impact on survival and heart failure 
      admissions, even in patients with reverse left ventricular remodeling. 
      CONCLUSIONS: Reverse ventricular remodeling and improvement in functional status 
      after CRT implantation are independent from comorbidity burden. However, comorbid 
      conditions remain important predictors of all-cause mortality and heart failure 
      admissions.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Verbrugge, Frederik H
AU  - Verbrugge FH
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
FAU - Dupont, Matthias
AU  - Dupont M
FAU - Rivero-Ayerza, Maximo
AU  - Rivero-Ayerza M
FAU - de Vusser, Philippe
AU  - de Vusser P
FAU - Van Herendael, Hugo
AU  - Van Herendael H
FAU - Vercammen, Jan
AU  - Vercammen J
FAU - Jacobs, Linda
AU  - Jacobs L
FAU - Verhaert, David
AU  - Verhaert D
FAU - Vandervoort, Pieter
AU  - Vandervoort P
FAU - Tang, W H Wilson
AU  - Tang WH
FAU - Mullens, Wilfried
AU  - Mullens W
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Cohort Studies
MH  - Comorbidity
MH  - Female
MH  - Heart Failure/*epidemiology/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ventricular Remodeling/*physiology
EDAT- 2012/11/13 06:00
MHDA- 2013/08/24 06:00
CRDT- 2012/11/13 06:00
PHST- 2012/05/08 00:00 [received]
PHST- 2012/08/16 00:00 [revised]
PHST- 2012/09/14 00:00 [accepted]
PHST- 2012/11/13 06:00 [entrez]
PHST- 2012/11/13 06:00 [pubmed]
PHST- 2013/08/24 06:00 [medline]
AID - S1071-9164(12)01265-1 [pii]
AID - 10.1016/j.cardfail.2012.09.003 [doi]
PST - ppublish
SO  - J Card Fail. 2012 Nov;18(11):845-53. doi: 10.1016/j.cardfail.2012.09.003.