PMID- 35791276 OWN - NLM STAT- MEDLINE DCOM- 20221011 LR - 20230106 IS - 1879-0844 (Electronic) IS - 1388-9842 (Print) IS - 1388-9842 (Linking) VI - 24 IP - 9 DP - 2022 Sep TI - Baseline clinical characteristics of heart failure patients with reduced ejection fraction enrolled in the BUDAPEST-CRT Upgrade trial. PG - 1652-1661 LID - 10.1002/ejhf.2609 [doi] AB - AIMS: The BUDAPEST-CRT Upgrade study is the first prospective, randomized, multicentre clinical trial investigating the outcomes after cardiac resynchronization therapy (CRT) upgrade in heart failure (HF) patients with intermittent or permanent right ventricular (RV) pacing with wide paced QRS. This report describes the baseline clinical characteristics of the enrolled patients and compares them to cohorts from previous milestone CRT studies. METHODS AND RESULTS: This international multicentre randomized controlled trial investigates 360 patients having a pacemaker (PM) or implantable cardioverter defibrillator (ICD) device for at least 6 months prior to enrolment, reduced left ventricular ejection fraction (LVEF /=20% of RV pacing burden without having a native left bundle branch block. At enrolment, the mean age of the patients was 73 +/- 8 years; 89% were male, 97% were in NYHA class II/III functional class, and 56% had atrial fibrillation. Enrolled patients predominantly had conventional PM devices, with a mean RV pacing burden of 86%. Thus, this is a patient cohort with advanced HF, low baseline LVEF (25 +/- 7%), high N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (2231 pg/ml [25th-75th percentile 1254-4309 pg/ml]), and frequent HF hospitalizations during the preceding 12 months (50%). CONCLUSION: When compared with prior CRT trial cohorts, the BUDAPEST-CRT Upgrade study includes older patients with a strong male predominance and a high burden of atrial fibrillation and other comorbidities. Moreover, this cohort represents an advanced HF population with low LVEF, high NT-proBNP, and frequent previous HF events. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT02270840. CI - (c) 2022 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Merkely, Bela AU - Merkely B AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Geller, Laszlo AU - Geller L AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Zima, Endre AU - Zima E AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Osztheimer, Istvan AU - Osztheimer I AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Molnar, Levente AU - Molnar L AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Foldesi, Csaba AU - Foldesi C AD - Gottsegen National Cardiovascular Center, Budapest, Hungary. FAU - Duray, Gabor AU - Duray G AD - Department of Cardiology, Hungarian Defence Forces Medical Centre, Budapest, Hungary. FAU - Wranicz, Jerzy K AU - Wranicz JK AD - Department of Electrocardiology, Medical University of Lodz, Lodz, Poland. FAU - Nemeth, Marianna AU - Nemeth M AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Goscinska-Bis, Kinga AU - Goscinska-Bis K AD - Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland. FAU - Hatala, Robert AU - Hatala R AD - Department of Cardiology and Angiology, National Institute of Cardiovascular Diseases and Slovak Medical University, Bratislava, Slovakia. FAU - Saghy, Laszlo AU - Saghy L AD - Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Szeged, Hungary. FAU - Veres, Boglarka AU - Veres B AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Schwertner, Walter Richard AU - Schwertner WR AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Fabian, Alexandra AU - Fabian A AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Fodor, Eszter AU - Fodor E AD - Pharmahungary Group, Szeged, Hungary. FAU - Goldenberg, Ilan AU - Goldenberg I AD - Clinical Cardiovascular Research Center, University of Rochester, Rochester, NY, USA. FAU - Kutyifa, Valentina AU - Kutyifa V AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. AD - Clinical Cardiovascular Research Center, University of Rochester, Rochester, NY, USA. FAU - Kovacs, Attila AU - Kovacs A AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Kosztin, Annamaria AU - Kosztin A AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. LA - eng SI - ClinicalTrials.gov/NCT02270840 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220722 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM CIN - Eur J Heart Fail. 2022 Sep;24(9):1662-1664. PMID: 35923074 MH - Aged MH - Aged, 80 and over MH - *Atrial Fibrillation/etiology/therapy MH - *Cardiac Resynchronization Therapy/methods MH - Female MH - *Heart Failure MH - Humans MH - Male MH - Natriuretic Peptide, Brain MH - Prospective Studies MH - Stroke Volume MH - Treatment Outcome MH - *Ventricular Dysfunction, Left MH - Ventricular Function, Left PMC - PMC9796950 OTO - NOTNLM OT - Cardiac resynchronization therapy OT - Cardiac resynchronization therapy upgrade OT - Pacing-induced cardiomyopathy OT - Right ventricular pacing OT - Upgrade EDAT- 2022/07/07 06:00 MHDA- 2022/10/12 06:00 PMCR- 2022/12/28 CRDT- 2022/07/06 01:28 PHST- 2022/06/23 00:00 [revised] PHST- 2022/04/03 00:00 [received] PHST- 2022/07/02 00:00 [accepted] PHST- 2022/07/07 06:00 [pubmed] PHST- 2022/10/12 06:00 [medline] PHST- 2022/07/06 01:28 [entrez] PHST- 2022/12/28 00:00 [pmc-release] AID - EJHF2609 [pii] AID - 10.1002/ejhf.2609 [doi] PST - ppublish SO - Eur J Heart Fail. 2022 Sep;24(9):1652-1661. doi: 10.1002/ejhf.2609. Epub 2022 Jul 22.