PMID- 29225103
OWN - NLM
STAT- MEDLINE
DCOM- 20190102
LR  - 20190102
IS  - 2174-2030 (Electronic)
IS  - 0870-2551 (Linking)
VI  - 36
IP  - 12
DP  - 2017 Dec
TI  - What happens to non-responders in cardiac resynchronization therapy?
PG  - 885-892
LID - S0870-2551(16)30370-5 [pii]
LID - 10.1016/j.repc.2017.02.017 [doi]
AB  - INTRODUCTION AND OBJECTIVES: Left ventricular reverse remodeling (LVRR) is 
      strongly related to the long-term prognosis of patients undergoing cardiac 
      resynchronization therapy (CRT). The aim of this study was to assess the 
      long-term clinical outcome of patients without LVRR at six months after CRT 
      implantation and to determine the prognostic impact of clinical response in this 
      population. METHODS: We analyzed 178 consecutive patients who underwent 
      successful CRT device implantation (age 64+/-11 years; 69% male; 89% in New York 
      Heart Association [NYHA] functional class III; 35% with ischemic cardiomyopathy). 
      Clinical status and echocardiographic parameters were determined before and six 
      months after CRT implantation. We identified those without criteria for LVRR 
      (>/=10% increase in left ventricular ejection fraction with >/=15% reduction in left 
      ventricular end-systolic diameter compared to baseline). Clinical responders were 
      defined by a sustained improvement of at least one NYHA functional class. 
      RESULTS: At six-month assessment after CRT, 109 (61%) patients showed LVRR. 
      During a mean follow-up of 56+/-21 months, 47 (26%) patients died, with higher 
      mortality in the group without LVRR (36% vs. 20%, p=0.023). Clinical response was 
      greater in patients with LVRR (88% vs. 55%, p<0.001). In patients without LVRR, 
      clinical response to CRT was the strongest independent predictor of survival 
      (hazard ratio: 0.120; 95% confidence interval: 0.039-0.366; p<0.001). CONCLUSION: 
      Although patients without LVRR six months after CRT implantation had a worse 
      prognosis, with higher all-cause mortality, clinical response can be an 
      independent predictor of survival in this population.
CI  - Copyright (c) 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier 
      Espana, S.L.U. All rights reserved.
FAU - Rio, Pedro
AU  - Rio P
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal. Electronic address: pedrosantosrio@gmail.com.
FAU - Oliveira, Mario Martins
AU  - Oliveira MM
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Cunha, Pedro Silva
AU  - Cunha PS
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - da Silva, Manuel Nogueira
AU  - da Silva MN
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Branco, Luisa Moura
AU  - Branco LM
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Galrinho, Ana
AU  - Galrinho A
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Soares, Rui
AU  - Soares R
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Feliciano, Joana
AU  - Feliciano J
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Pimenta, Ricardo
AU  - Pimenta R
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
FAU - Ferreira, Rui Cruz
AU  - Ferreira RC
AD  - Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa 
      Central, Lisbon, Portugal.
LA  - eng
LA  - por
PT  - Journal Article
DEP - 20171208
PL  - Portugal
TA  - Rev Port Cardiol
JT  - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de 
      Cardiologia = Portuguese journal of cardiology : an official journal of the 
      Portuguese Society of Cardiology
JID - 8710716
SB  - IM
CIN - Rev Port Cardiol. 2017 Dec;36(12 ):893-894. PMID: 29233645
MH  - *Cardiac Resynchronization Therapy
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Failure
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Clinical response
OT  - Heart failure
OT  - Insuficiencia cardiaca
OT  - Prognosis
OT  - Prognostico
OT  - Resposta clinica
OT  - Terapia de ressincronizacao cardiaca
EDAT- 2017/12/12 06:00
MHDA- 2019/01/03 06:00
CRDT- 2017/12/12 06:00
PHST- 2016/11/26 00:00 [received]
PHST- 2017/02/14 00:00 [revised]
PHST- 2017/02/23 00:00 [accepted]
PHST- 2017/12/12 06:00 [pubmed]
PHST- 2019/01/03 06:00 [medline]
PHST- 2017/12/12 06:00 [entrez]
AID - S0870-2551(16)30370-5 [pii]
AID - 10.1016/j.repc.2017.02.017 [doi]
PST - ppublish
SO  - Rev Port Cardiol. 2017 Dec;36(12):885-892. doi: 10.1016/j.repc.2017.02.017. Epub 
      2017 Dec 8.