Response and long-term outcomes with resynchronization therapy: the role of heart failure etiology

Abstract Background Resynchronization therapy (CRT) reduces mortality across all etiologies of heart failure (HF). Reverse left ventricular (LV) remodelling has been reported to occur more often in non-ischemic patients. Purpose To compare response and outcomes after CRT (NIHF) ischemic (IHF) HF Methods Single-center retrospective study consecutive patients submitted implantation (2007–2018). Major adverse cardiac events (MACE) included hospitalization or all-cause (ACM). Clinical was defined as New York Heart Association (NYHA) class improvement without MACE the 1st year follow-up (FU). Echocardiographic (echo) implied ventricle end-systolic volume reduction >15% at 1-year. LV ejection fraction [LVEF] ≥50% during FU superresponse. Survival analysis with Kaplan-Meier method Log-rank test performed outcomes. Multivariate assess if etiology predicted CRT. Results 295 (mean age 67±11 years, 91.5% bundle branch block, baseline QRS 171±22 ms) were included. Patients NIHF group (n=208, 72.5%) female (35.6% vs 15.6%, p<0.001), tended be younger (67 70 p=0.05), had valve disease (36.7% 23.6%, p=0.037) kidney (32.9% 18.5%, p=0.015). In patients, right dysfunction (tricuspid annular plane systolic excursion <17 mm) less common (25.6% 47.1%, p=0.039). Addition defibrillator identical (53.8% 55.7%, p=0.882). NYHA (79.4% 78.4%, p=0.987) echo (71.2% 74.4%, p=0.860) similar. superresponders (25.7% 9.5%, p=0.006), greater LVEF (Δ 11.6% 7.6%, p<0.001). frequent (66.3% 50.6%, p=0.023). After multivariate analysis, not predictive clinical (p=0.960) (p=0.075). During a mean 3.8 occurrence (Log rank test, p<0.001) ACM lower [Figure 1]. Ventricular arrythmias (6.4% 7.5%, p=0.993) appropriate therapies (5.3% p=0.743) did differ. Conclusions this cohort, consisting mostly LBBB ≥150 ms, predict Still, showed extent remodelling. Lower rates also observed Funding Acknowledgement Type funding sources: None.