Heart failure hospitalizations, heart failure death, cardiac death and all-cause mortality were pre-specified study endpoints. Specifically, we focused on endsystolic LV diameter, NYHA class and NT-proBNP, either in absolute 12-month values as well as their relative change compared to baseline. In the same population with prolonged follow up, we investigated the long-term prognostic value of short-term (1-year) CRT response on top of baseline clinical characteristics. In our previous study, we showed that electrical LV lead position at implant assessed by Q-LV ratio (electrical delay from the beginning of the QRS complex to the local LV electrogram/QRS duration) was found to be a significant predictor of mortality in CRT patients. There is a great interest in the early identification not only of determinants of CRT response but also predictors of future clinical events. However, approximately 30% of patients fail to respond to CRT. When post-CRT relative change of LV end-systolic diameter and 12-month level of NT-proBNP (dichotomized at -12.3% and 1230 ng/L, respectively) were combined, subgroups of very-high and very-low risk patients were identified.Ĭardiac resynchronization therapy (CRT) has become an established and important treatment for chronic heart failure (HF) patients with left ventricular (LV) systolic dysfunction and left bundle branch block (LBBB). Both reverse LV remodeling and 12-month level of NT-proBNP were independent and comparable predictors of CRT-related clinical outcome, while NT-proBNP response had the strongest association with all-cause mortality. For NT-proBNP, however, the 12-month level was a stronger predictor than the change from baseline. Post-CRT LV ejection fraction and LV end-systolic diameter (either 12-month value or the change from baseline) were equally predictive for clinical events. During a follow-up period of 4.8☒.1 years from CRT implantation, 35.2% patients died from cardiac (19.3%) or non-cardiac (15.9%) causes. A total of 315 patients with left bundle branch block or intraventricular conduction delay who survived >1 year after CRT implantation were analyzed in the current study.
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