Abstract 16565: Long-Term Follow-Up in Patients with no Worsening, but Non-Significant Improvement in Left Ventricular End-Systolic Volume following Cardiac Resynchronization Therapy
Introduction: Cardiac Resynchronization Therapy (CRT) is a well established treatment for patients with heart failure. A decrease in left ventricular end-systolic volume (LVESV) has been proposed to assess treatment success. Accordingly, patients can be divided into responders and non-responders, based on a cutoff of 15% decrease in LVESV. However, there remains a group of patients that show a reduction in LVESV, but not enough to be marked as responder. Consequently, the aim of this study was to determine the survival benefit of patients that do not worsen, but don't show significant improvement.
Methods: A total of 463 patients in NYHA class III or IV undergoing CRT were included. Patients with a reduction in LVESV ≥15% at 6 months follow-up were marked as responders, while patients showing no increase, but also no significant decrease (<15%) in LVESV were marked as non responders. All-cause mortality was assessed during long-term follow-up.
Results: Out of 463 patients, 358 could be marked as responders and 105 patients as non-responders. During a mean follow-up of 39 months, 103 (22.2%) patients died. After correction for baseline characteristics, survival was significantly higher in responders as compared to non-responders (Figure).
Conclusion: Although CRT can delay disease progression and thereby improve long-term outcome, a large reduction (≥15%) in LVESV at mid-term follow-up resulted in better survival as compared to a non-significant reduction in LVESV.
- © 2010 by American Heart Association, Inc.