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Cardiac resynchronization therapy is effective even in elderly patients with comorbidities

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to compare the effects of cardiac resynchronization therapy (CRT) in elderly patients (≥65 years) with younger patients and to assess the impact of comorbidities in CRT remodeling response.

Methods

This is a prospective study of 87 consecutive patients scheduled for CRT who underwent clinical and echocardiographic evaluation before and 6 months after CRT. A reduction in left ventricular end-systolic volume (LVESV) ≥15% after CRT defined remodeling responders, and a reduction of at least one New York Heart Association class defined clinical responders. Multivariate analysis was used to identify independent predictors of non-response to CRT in terms of reverse remodeling.

Results

The mean age was 62 ± 11 years, with 36 elderly patients (41%). The baseline QRS duration was 145 ± 32 ms. After CRT, there were significant and similar improvements of left ventricular (LV) ejection fraction, LVESV, LV dP/dt, and mitral regurgitation jet area (JA) between elderly (≥65 years) and younger (<65 years) patients. The number of clinical and remodeling responders was comparable, and we found no significant differences in unplanned cardiac hospitalizations at 6 months between groups. Independent predictors of lack of remodeling response to CRT were QRS duration <120 ms, LV diastolic diameter >74 mm, and JA >10 cm2 before CRT, but not comorbidities.

Conclusion

This work suggests that being elderly is not an impediment to CRT success even in the presence of comorbidities.

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Acknowledgments

The authors thank the Portuguese Society of Cardiology/CNCDC (Centro Nacional de Colecção de Dados em Cardiologia) for their guidance and suggestions on statistical analyses.

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Authors and Affiliations

  1. Department of Cardiology, Coimbra University Hospital and Medical School, Avenida Bissaya Barreto, 3000-076, Coimbra, Portugal

    Natália António, Carolina Lourenço, Rogério Teixeira, Fátima Saraiva, Lourenço Coelho, Miguel Ventura, João Cristóvão, Luís Elvas, Lino Gonçalves & Luís A. Providência

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  1. Natália António
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Correspondence to Natália António.

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António, N., Lourenço, C., Teixeira, R. et al. Cardiac resynchronization therapy is effective even in elderly patients with comorbidities. J Interv Card Electrophysiol 27, 61–68 (2010). https://doi.org/10.1007/s10840-009-9449-9

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  • DOI: https://doi.org/10.1007/s10840-009-9449-9

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