scholarly journals Predictors of mortality, LVAD implant, or heart transplant in primary prevention cardiac resynchronization therapy recipients: The HF-CRT score

Heart Rhythm ◽  
2015 ◽  
Vol 12 (12) ◽  
pp. 2387-2394 ◽  
Author(s):  
Victor Nauffal ◽  
Tanyanan Tanawuttiwat ◽  
Yiyi Zhang ◽  
John Rickard ◽  
Joseph E. Marine ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Cardiac Resynchronization Therapy ◽  
Heart Transplant ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Predictors Of Mortality

All-cause mortality and cardiac resynchronization therapy with or without defibrillation in primary prevention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Bisson
Keyword(s):  
Primary Prevention ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Real Life ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Total Study Population ◽  
Life Study ◽  
All Cause Mortality ◽  
Study Population

Abstract Aims Cardiac resynchronization therapy with (CRTD) or without (CRTP) defibrillator is recommended in selected patient with systolic chronic heart failure and wide QRS. There is no guideline firmly indicating choice between CRTP and CRTD in primary prevention, particularly in older patients. Methods Based on the French administrative hospital-discharge database, information was collected from 2010 to 2017 for all patients implanted with CRTP or CRTD in primary prevention. Outcomes analyses were undertaken in the total study population and in propensity-matched samples. Results A total of 45,697 patients were analyzed (19,266 with CRTP and 26,431 with CRTD). The nationwide numbers of implantations increased between 2010 and 2017 (+29.6% for CRTD, +28.8% for CRTP). Proportion of CRTP implantation over CRTD remained similar over these years. During follow up (913 days, SD 841, median 701, IQR 151–1493), incidence rate (%patient/year) of all-cause mortality was higher in CRTP (11.6%) than in CRTD patients (6.8%) (Hazard Ratio [HR] 1.70, 95% CI 1.63–1.76, p<0.001). After propensity-matched analyses, mortality of patients over 75 years-old with non-ischemic cardiomyopathy (NICM) was not different with CRTP and CRTD (HR 0.93, 95% CI 0.80–1.09, p=0.39). CRTP patients under 75 yo with NICM had a higher mortality than CRTD patients (HR 1.22, 95% CI 1.08–1.37, p=0.01). Mortality rate was also higher with CRTP than with CRTD irrespectively of age in patients with ischemic cardiomyopathy (ICM) (<75 yo: HR 1.13, 95% CI 1.04–1.33, p<0.01; ≥75 yo: HR 1.22, 95% CI 1.08–1.37, p=0.01). Conclusion This real-life study gives up-to-date information about unselected patients implanted with CRTP and CRTD in primary prevention, and provides additional data which may help physicians choosing between CRTP and CRTD at the time of implantation. Benefit of CRTD seemed clear for all-cause mortality in patients with ICM and in patients with NICM under 75 yo. Patients over 75 yo with NICM seemed less likely to benefit from primary prevention CRTD implantation. Event free curves for mortality outcomes Funding Acknowledgement Type of funding source: None

scholarly journals Resynchronization therapy in end-stage heart failure

2021 ◽  
Vol 5 (4) ◽  
pp. 206-211
Author(s):  
D.V. Shumakov ◽  
◽  
D.I. Zybin ◽  
M.A. Popov ◽  
V.V. Dontsov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Resynchronization Therapy ◽  
Heart Transplant ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Resynchronization Therapy ◽  
End Stage Heart Failure ◽  
End Stage

Heart failure (HF) is a common condition, and its overall prevalence is constantly growing. HF ultimately progresses to end-stage disease that is refractory to optimal medical therapy and requires implantable devices or heart transplant. In recent years, cardiac resynchronization therapy (CRT) has been generally accepted in patients with NYHA class III or IV, reduced left ventricular ejection fraction (less than 35%), and the wide QRS complex (>120 msec). CRT improves the efficacy of heart ventricle function and, as a result, physical performance and quality of life. Reverse cardiac remodeling occurs at a pathophysiological level that improves systolic function. Patients with end-stage HF who are on the heart transplant list are a specific group in whom CRT is considered a “bridge” to surgery. This review paper discusses state-of-the-art, advances, and unresolved issues in this area. KEYWORDS: cardiac resynchronization therapy, heart failure, left ventricular remodeling, ejection fraction, heart transplant. FOR CITATION: Shumakov D.V., Zybin D.I., Popov M.A. et al. Resynchronization therapy in end-stage heart failure. Russian Medical Inquiry. 2021;5(4):206–211 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-206-211.

scholarly journals The neutrophil to lymphocyte ratio in heart failure: a comprehensive review

2019 ◽  
Vol 57 (4) ◽  
pp. 296-314
Author(s):  
Caterina Delcea ◽  
Cătălin Adrian Buzea ◽  
Gheorghe Andrei Dan
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Implantable Cardioverter Defibrillator ◽  
Heart Transplant ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Comprehensive Review ◽  
Cardioverter Defibrillator ◽  
Lymphocyte Ratio

Abstract Introduction. Heart failure (HF) and systemic inflammation are interdependent processes that continuously potentiate each other. Distinct pathophysiological pathways are activated, resulting in increased neutrophil count and reduced lymphocyte numbers, making the neutrophil to lymphocyte ratio (NLR) a potential indirect marker of severity. We conducted this comprehensive review to characterize the role of NLR in HF. Methods. We searched the PubMed (MEDLINE) database using the key words “neutrophil”, “lymphocyte”, “heart failure”, “cardiomyopathy”, “implantable cardioverter defibrillator”, “cardiac resynchronization therapy” and “heart transplant”. Results. We identified 241 publications. 31 were selected for this review, including 12,107 patients. NLR was correlated to HF severity expressed by clinical, biological, and imaging parameters, as well as to short and long-term prognosis. Most studies reported its survival predictive value. Elevated NLR (>2.1–7.6) was an independent predictor of in-hospital mortality [adjusted HR 1.13 (95% CI 1.01–1.27) – 2.8 (95% CI 1.43–5.53)] as well as long-term all-cause mortality [adjusted HR 1.43 (95% CI 1.1–1.85) – 2.403 (95% CI 1.076–5.704)]. Higher NLR levels also predicted poor functional capacity [NLR > 2.26/2.74, HR 3.93 (95% CI 1.02–15.12) / 3.085 (95% CI 1.52–6.26)], hospital readmissions [NLR > 2.9/7.6, HR 1.46 (95% CI 1.10–1.93) / 3.46 (95% CI 2.11–5.68)] cardiac resynchronization therapy efficacy [NLR > 3.45/unit increase, HR 12.22 (95% CI 2.16–69.05) / 1.51 (95% CI 1.01–2.24)] and appropriate implantable cardioverter defibrillator shocks (NLR > 2.93), as well as mortality after left ventricular assist device implantation [NLR > 4.4 / quartiles, HR 1.67 (95% CI 1.03–2.70) / 1.22 (95% CI 1.01–1.47)] or heart transplant (NLR > 2.41, HR 3.403 (95% CI 1.04–11.14)]. Conclusion. Increased NLR in HF patients can be a valuable auxiliary biomarker of severity, and most of all, of poor prognosis.

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