Abstract 826: Cardiac Resynchronisation Therapy in Elderly Patients: Effects on Left Ventricular Remodeling. A Secondary Analysis from CARE-HF
In elderly patients, controlled data on the clinical efficacy and safety of cardiac resynchronization therapy (CRT) are very scarce. The CARE-HF study was the first multi-center randomised trial to demonstrate that CRT by atrio-biventricular pacing improves symptoms and the quality of life while reducing all-cause mortality and major morbidity in NYHA Class III-IV HF patients with wide QRS. These clinical results were associated with a positive left ventricular reverse remodelling (LVRR). This post-hoc analysis reports data on LVRR in the sub-population of patients aged ≥70 yrs. 302 pts, mean age 75.1 yrs, were randomized to CRT (N=157) or medical treatment (MT:N=145) and followed for a mean of 28.9 months. There were no significant differences between the two groups in baseline characteristics including HF pharmacological treatment. Overall, 91.7% pts received ACE-I or ARB and 64.8% a Beta-blocker. HF was of ischemic etiology in 51% pts and mean QRS width was 165 ms. Echocardiography was evaluated at baseline and at 18 months follow-up.
Conclusion: In elderly patients with moderate to severe heart failure and wide QRS, CRT results in a highly significant and sustained improvement in left ventricular reverse remodelling as well as in the overall population