Clinical and echocardiographical response and decrease of NT-proBNP levels at one year predict long term outcome after cardiac resynchronization therapy

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27283933%3A_____%2F18%3A00005970" target="_blank" >RIV/27283933:_____/18:00005970 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/27283933:_____/18:00006560

Výsledek na webu

<a href="http://academic.oup.com/europace/article-pdf/20/suppl_1/i51/24315223/euy015.138.pdf" target="_blank" >http://academic.oup.com/europace/article-pdf/20/suppl_1/i51/24315223/euy015.138.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/europace/euy015.138" target="_blank" >10.1093/europace/euy015.138</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Clinical and echocardiographical response and decrease of NT-proBNP levels at one year predict long term outcome after cardiac resynchronization therapy

Popis výsledku v původním jazyce

Introduction: Approximately 30% of patients fail to respond to CRT. There is still substantial interest in early identifying determinants and predictors of future clinical events. Purpose: Our study was designed to evaluate the long term prognostic value of short term CRT response (clinical, echocardiographical and NT-proBNP changes). Methods: Data from a prospective database of CRT patients implanted between 2005 and 2013 in one center were analyzed. Echocardiographically measured left ventricle (LV) reverse remodeling, NYHA class and NT-proBNP levels were assessed one year after CRT implantation and their link to heart failure (HF) hospitalizations and mortality (HF and all-cause) were analysed. Results: 328 CRT patients with LBBB or IVCD were included. 13 patients were excluded because of death within the first year. During the follow-up period of 4.8±2.1 years 35.2% patients died from cardiac (19.3%) or non-cardiac (15.9%) causes and 82 patients (26%) were hospitalized for HF after the 12 months visit. The most significant parameter in univariate Cox regression analysis for all clinical endpoints was echocardiographically assessed reversal remodeling of LV: relative change of the LV end-systolic diameter (LVESd) >-13% (median value) with RR 3.2 (CI 2.0-5.2, p?0.0001) for HF hospitalization, RR 8.7 (CI 3.7-20.7, p?0.0001) for HF death and RR 2.9 (CI 1.9-4.4, p?0.0001) for all-cause death. NYHA class change =0 had RR 2.3 (CI 1.4-3.7, p=0.0006) for HF hospitalization, RR 5.5 (CI 2.8-10.9, p?0.0001) for HF death and RR 2.0 (CI 1.3-3.1, p=0.0007) for all-cause death. BNP relative difference >-43% (median value) had RR 2.6 (CI 1.6-4.1, p=0.0001) for HF hospitalization, RR 1.9 (CI 1.0-3.7, p=0.04) for HF death and RR 2.2 (CI 1.5-3.4, p=0.0001) for all-cause death. Event-free survival curves for LV reversal remodeling (LVESd) are shown in Fig 1. Conclusion: Reversal remodeling of the left ventricle is (compared to NYHA class change and decrease of NT-proBNP values) the most significant predictor of future clinical events in CRT patients.

Název v anglickém jazyce

Clinical and echocardiographical response and decrease of NT-proBNP levels at one year predict long term outcome after cardiac resynchronization therapy

Popis výsledku anglicky

Introduction: Approximately 30% of patients fail to respond to CRT. There is still substantial interest in early identifying determinants and predictors of future clinical events. Purpose: Our study was designed to evaluate the long term prognostic value of short term CRT response (clinical, echocardiographical and NT-proBNP changes). Methods: Data from a prospective database of CRT patients implanted between 2005 and 2013 in one center were analyzed. Echocardiographically measured left ventricle (LV) reverse remodeling, NYHA class and NT-proBNP levels were assessed one year after CRT implantation and their link to heart failure (HF) hospitalizations and mortality (HF and all-cause) were analysed. Results: 328 CRT patients with LBBB or IVCD were included. 13 patients were excluded because of death within the first year. During the follow-up period of 4.8±2.1 years 35.2% patients died from cardiac (19.3%) or non-cardiac (15.9%) causes and 82 patients (26%) were hospitalized for HF after the 12 months visit. The most significant parameter in univariate Cox regression analysis for all clinical endpoints was echocardiographically assessed reversal remodeling of LV: relative change of the LV end-systolic diameter (LVESd) >-13% (median value) with RR 3.2 (CI 2.0-5.2, p?0.0001) for HF hospitalization, RR 8.7 (CI 3.7-20.7, p?0.0001) for HF death and RR 2.9 (CI 1.9-4.4, p?0.0001) for all-cause death. NYHA class change =0 had RR 2.3 (CI 1.4-3.7, p=0.0006) for HF hospitalization, RR 5.5 (CI 2.8-10.9, p?0.0001) for HF death and RR 2.0 (CI 1.3-3.1, p=0.0007) for all-cause death. BNP relative difference >-43% (median value) had RR 2.6 (CI 1.6-4.1, p=0.0001) for HF hospitalization, RR 1.9 (CI 1.0-3.7, p=0.04) for HF death and RR 2.2 (CI 1.5-3.4, p=0.0001) for all-cause death. Event-free survival curves for LV reversal remodeling (LVESd) are shown in Fig 1. Conclusion: Reversal remodeling of the left ventricle is (compared to NYHA class change and decrease of NT-proBNP values) the most significant predictor of future clinical events in CRT patients.

Druh

O - Ostatní výsledky

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů