Abstract 16390: Long-Term Clinical Outcomes in NYHA I-II Patients After Cardiac Resynchronization Therapy: Sub-Group Analysis From CUBIC Registry
Background: Long term clinical outcomes of mild heart failure patients (pts) after cardiac resynchronization therapy (CRT) is not well known.
Methods: We investigated 651 pts from CUBIC study which is a multi-center CRT registry in Japan. (age 69+/-11years, NYHA class 2.9+/-0.6, LVEF 28+/-9%, LVEDD 62+/-9mm, QRS duration 150+/-37ms, CRT-D 58%) and divided into two groups, 139 pts with none or mild heart failure before CRT (NYHA I-II group), 512 pts with moderate to severe heart failure (NYHA III-IV group).
Results: Mean follow up were 22+/15 months. There was no improvement of NYHA class at 6 months in NYHA I-II group. However, the rate of reverse LV remodeling defined as LV end-systolic volume reduction > 15% after 6 months was equivalent between NYHA I-II group and NYHA III-IV group (56% vs.64%, p=ns) and improvement of BNP levels were also equivalent (NYHA I-II group: -151pg/dl vs. NYHA III-IV group: -230pg/dl, p=ns).The event free survival rates from death, heart failure hospitalization, combined death and heart failure hospitalization and ventricular arrhythmic events were all significantly higher in NYHA I-II group (89 % vs.80% at 2 years, Log-rank p=0.015, 87% vs.67% at 2 years, Log-rank p=0.0003, 82% vs.59% at 2 years, Log-rank p<0.0001 and 87% vs.81%, Log-rank p=0.047, respectively).
Conclusion: Pts with none or mild heart failure had a significantly better clinical outcomes compared to pts with moderate to severe heart failure after CRT.
- © 2011 by American Heart Association, Inc.