PMID- 26325259
OWN - NLM
STAT- MEDLINE
DCOM- 20160801
LR  - 20150902
IS  - 1898-018X (Electronic)
IS  - 1898-018X (Linking)
VI  - 22
IP  - 4
DP  - 2015
TI  - Renal function impairment predicts mortality in patients with chronic heart 
      failure treated with resynchronization therapy.
PG  - 459-66
LID - 10.5603/CJ.a2015.0019 [doi]
AB  - BACKGROUND: The use of cardiac resynchronization therapy (CRT) and implantable 
      cardioverter- defibrillator (ICD) for advanced heart failure (HF) is increasing. 
      Renal dysfunction is a common condition in HF which is associated with a worse 
      survival. The study aims at identifying in patients with advanced HF treated with 
      CRT the effect of baseline glomerular filtration rate (GFR), GFR improvement and 
      left ventricular ejection fraction (LVEF) change, after 6-months of CRT implant, 
      on survival. METHODS: The study population consisted of 375 advanced HF patients 
      who received a CRT between 1999 and 2009, of these 277 received also an ICD 
      implant. Clinical characteristics (New York Heart Association [NYHA] functional 
      class, ischemic vs. non-ischemic etiology, atrial fibrillation, diabetes, 
      hypertension, LVEF, QRS duration and GFR were recorded. The use of common used 
      drugs was evaluated. Cox proportional hazards analysis was calculated in order to 
      evaluate variables associated to mortality. RESULTS: During a median follow-up of 
      43.0 months, 93 (24.8%) patients died. Patients deceased during the study had at 
      baseline higher NYHA class and lower LVEF and GFR. In Cox regression analysis, 
      GFR predicts long-term mortality (hazard ratio [HR] 0.983; 95% confidence 
      interval [CI] 0.969-0.998; p = 0.023) independently from the effect of others 
      covariates. In addition, a positive GFR improvement 6 months after CRT implant is 
      significantly associated with a lower hazard of mortality (for each 10 mL/min of 
      GFR improvement HR 0.86; 95% CI 0.75-0.99; p = 0.038). CONCLUSIONS: GFR is a 
      significant predictor of mortality in advanced HF patients who received CRT. A 
      GFR improvement 6 months after CRT implant is significantly associated with a 
      lower hazard of mortality.
FAU - Gronda, Edoardo
AU  - Gronda E
FAU - Genovese, Stefano
AU  - Genovese S
FAU - Padeletti, Luigi
AU  - Padeletti L
FAU - Cacciatore, Francesco
AU  - Cacciatore F
FAU - Vitale, Dino Franco
AU  - Vitale DF
FAU - Bragato, Renato
AU  - Bragato R
FAU - Innocenti, Lisa
AU  - Innocenti L
FAU - Schiano, Concetta
AU  - Schiano C
FAU - Sommese, Linda
AU  - Sommese L
FAU - De Pascale, Maria Rosaria
AU  - De Pascale MR
FAU - Genovese, Luca
AU  - Genovese L
FAU - Abete, Pasquale
AU  - Abete P
FAU - Donatelli, Francesco
AU  - Donatelli F
FAU - Napoli, Claudio
AU  - Napoli C
AD  - Fondazione Studio Diagnostica Nucleare, IRCCS, Naples, Italy Department of 
      Internal Medicine and Specialist Units, U.O.C. Immunohematology, and Excellence 
      Research Center on Cardiovascular Disease, 1st School of Medicine, Second 
      University of Naples, Naples, Italy. claudio.napoli@unina2.it.
LA  - eng
PT  - Journal Article
PL  - Poland
TA  - Cardiol J
JT  - Cardiology journal
JID - 101392712
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cardiac Resynchronization Therapy/adverse effects/mortality
MH  - Cardiac Resynchronization Therapy Devices
MH  - Chi-Square Distribution
MH  - Chronic Disease
MH  - Defibrillators, Implantable
MH  - *Electric Countershock/adverse effects/instrumentation/mortality
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Heart Failure/diagnosis/mortality/physiopathology/*therapy
MH  - Humans
MH  - Kidney/*physiopathology
MH  - Kidney Diseases/diagnosis/mortality/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Proportional Hazards Models
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - Young Adult
EDAT- 2015/09/02 06:00
MHDA- 2016/08/02 06:00
CRDT- 2015/09/02 06:00
PHST- 2014/12/02 00:00 [received]
PHST- 2015/03/02 00:00 [accepted]
PHST- 2015/02/06 00:00 [revised]
PHST- 2015/09/02 06:00 [entrez]
PHST- 2015/09/02 06:00 [pubmed]
PHST- 2016/08/02 06:00 [medline]
AID - VM/OJS/J/40349 [pii]
AID - 10.5603/CJ.a2015.0019 [doi]
PST - ppublish
SO  - Cardiol J. 2015;22(4):459-66. doi: 10.5603/CJ.a2015.0019.