Abstract | PURPOSE: Pulmonary artery hypertension is correlated with poor clinical prognosis in patients with chronic heart failure. However, there is a paucity of data concerning the impact of baseline pulmonary artery systolic pressure ( PASP) on clinical outcome after cardiac resynchronization therapy (CRT). The aim of the study is to evaluate the association of baseline PASP with CRT response. METHODS: One hundred eighty-seven consecutive patients undergoing CRT were screened for retrospective analysis. Patients were stratified into three groups based on preoperative PASP which was determined by echocardiogram (group I, PASP < 45 mmHg; group II, 45 mmHg ≤ PASP < 70 mmHg; and group III, PASP ≥ 70 mmHg). Clinical and echocardiographic improvements, as well as the response rate, were assessed 6 months after CRT. Long-term prognosis, measured as transplantation- and hospitalization-free survival, was also compared across the three groups. RESULTS: One hundred eighty-three patients were evaluated with a mean age of 60.7 ± 11.2 years. At 6-month follow-up, patients in group I demonstrated greater clinical improvements (p < 0.05) and higher response rate (p < 0.01) than groups II and III. Compared with group I, death or transplantation was significantly more often noted in group II (hazard ratio, 4.89; 95% CI, 1.53-15.60; p = 0.007) and group III (hazard ratio, 5.91; 95% CI, 1.25-27.94; p = 0.025) as was heart failure readmission for group II (hazard ratio, 2.48; 95% CI, 1.24-4.98; p = 0.011) and group III (hazard ratio, 6.39; 95% CI, 2.26-18.06; p < 0.001). CONCLUSIONS: Patients with elevated PASP derive less benefit from CRT. Baseline PASP could serve as an independent predictor for long-term prognosis.
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Authors | Jingfeng Wang, Yangang Su, Jin Bai, Wei Wang, Shengmei Qin, Junbo Ge |
Journal | Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
(J Interv Card Electrophysiol)
Vol. 40
Issue 2
Pg. 171-8
(Aug 2014)
ISSN: 1572-8595 [Electronic] Netherlands |
PMID | 24728706
(Publication Type: Journal Article, Observational Study)
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Topics |
- Blood Pressure Determination
(statistics & numerical data)
- Cardiac Resynchronization Therapy
(mortality, statistics & numerical data)
- China
(epidemiology)
- Chronic Disease
- Comorbidity
- Female
- Heart Failure
(diagnostic imaging, mortality, prevention & control)
- Humans
- Hypertension, Pulmonary
(diagnostic imaging, mortality)
- Male
- Middle Aged
- Prevalence
- Prognosis
- Reproducibility of Results
- Retrospective Studies
- Risk Factors
- Sensitivity and Specificity
- Survival Rate
- Treatment Outcome
- Ultrasonography
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