PMID- 27717763
OWN - NLM
STAT- MEDLINE
DCOM- 20171106
LR  - 20220408
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 22
IP  - 12
DP  - 2016 Dec
TI  - Mode of Death in Octogenarians Treated With Cardiac Resynchronization Therapy.
PG  - 970-977
LID - S1071-9164(16)31158-7 [pii]
LID - 10.1016/j.cardfail.2016.09.023 [doi]
AB  - BACKGROUND: Cardiac resynchronization therapy (CRT) improves morbidity and 
      mortality in heart failure with reduced ejection fraction (HFrEF) and electrical 
      dyssynchrony. CRT patients in clinical practice are older compared with clinical 
      trials. OBJECTIVE: To investigate clinical response, reverse remodeling, outcome, 
      and mode of death in octogenarians receiving CRT. METHODS: Baseline 
      characteristics, change in New York Heart Association (NYHA) functional class, 
      reverse ventricular remodeling, heart failure readmissions, all-cause mortality, 
      and mode of death were evaluated in CRT patients with comparison between 
      octogenarians and nonoctogenarians. In addition, annual mortality rates of 
      octogenarians undergoing CRT were compared with age-matched control subjects from 
      the general population with the use of national actuarial tables. RESULTS: A 
      total of 686 patients, including 178 octogenarians (26%), were followed for 
      38 +/- 22 months. Octogenarians exhibited a similar change in NYHA functional class 
      (P = .640), left ventricular ejection fraction increase (P = .796), and decrease 
      in end-diastolic (P = .441) and end-systolic (P = .312) diameter compared with 
      their younger counterparts undergoing CRT. Octogenarians had a higher all-cause 
      mortality risk (P < .001), but heart failure readmission risk did not differ 
      (hazard ratio 0.916, 95% confidence interval 0.638-1.313; P = .632). A higher 
      proportion of noncardiac deaths was observed in octogenarians (74%) versus 
      younger patients (50%; P = .022), with worsening heart failure rather than 
      malignant tachyarrhythmia being the main cardiac cause of death. Compared with an 
      age-matched sample from the general population, octogenarians receiving CRT had 
      an equivalent annual mortality rate (log-rank test: P = .444). CONCLUSIONS: 
      Octogenarians retain the ability to mount a significant symptomatic and 
      ventricular remodeling response after CRT, resulting in survival similar to the 
      general age-matched population.
CI  - Copyright A(c) 2016 Elsevier Inc. All rights reserved.
FAU - Martens, Pieter
AU  - Martens P
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Doctoral School 
      for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
FAU - Verbrugge, Frederik H
AU  - Verbrugge FH
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
FAU - Nijst, Petra
AU  - Nijst P
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Doctoral School 
      for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
FAU - Dupont, Matthias
AU  - Dupont M
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
FAU - Mullens, Wilfried
AU  - Mullens W
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Biomedical 
      Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, 
      Diepenbeek, Belgium. Electronic address: wmulle0@hotmail.com.
LA  - eng
PT  - Journal Article
DEP - 20161004
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
CIN - J Card Fail. 2016 Dec;22(12 ):978-980. PMID: 27765669
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cardiac Resynchronization Therapy
MH  - Female
MH  - Heart Failure/*mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Remodeling
OTO - NOTNLM
OT  - CRT
OT  - Elderly
OT  - heart failure readmission
OT  - reverse remodeling
EDAT- 2016/10/09 06:00
MHDA- 2017/11/07 06:00
CRDT- 2016/10/09 06:00
PHST- 2016/06/06 00:00 [received]
PHST- 2016/09/20 00:00 [revised]
PHST- 2016/09/29 00:00 [accepted]
PHST- 2016/10/09 06:00 [pubmed]
PHST- 2017/11/07 06:00 [medline]
PHST- 2016/10/09 06:00 [entrez]
AID - S1071-9164(16)31158-7 [pii]
AID - 10.1016/j.cardfail.2016.09.023 [doi]
PST - ppublish
SO  - J Card Fail. 2016 Dec;22(12):970-977. doi: 10.1016/j.cardfail.2016.09.023. Epub 
      2016 Oct 4.