Clinical outcomes and mortality in old and very old patients undergoing cardiac resynchronization therapy


Autoři: Luiz Eduardo Montenegro Camanho aff001;  Eduardo Benchimol Saad aff002;  Charles Slater aff002;  Luiz Antonio Oliveira Inacio Junior aff002;  Gustavo Vignoli aff002;  Lucas Carvalho Dias aff002;  Pedro Pimenta de Mello Spineti aff001;  Ricardo Mourilhe-Rocha aff001
Působiště autorů: Serviço e Disciplina de Cardiologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil aff001;  Serviço de Cardiologia e Arritmia Invasiva, Hospital Pró-Cardíaco, Rio de Janeiro, Brasil aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225612

Souhrn

Aim

Cardiac resynchronization therapy (CRT) is a valid therapeutic option for patients with heart failure (HF). However, the elderly population was not well represented in the guidelines. The primary end point was to evaluate the impact of advanced age on clinical response and cardiovascular and total mortality of patients undergoing CRT. The secondary end point was to assess the rate of acute complications related to the procedure.

Methods and results

A total of 249 consecutive patients with HF and optimized treatment, QRS ≥ 120 ms, ejection fraction (EF) ≤ 35% and functional class (FC) III/ IV (NYHA) underwent CRT and divided into 3 groups: Group I—< 65 years—88/ 249 (35%); Group II– 65 to 75 years (old)– 72/ 249 (29%); Group III—≥ 75 years (very old)– 89/ 249 (36%). The improvement in FC and increase in EF (>10%) and/ or decrease in the left ventricular end systolic diameter (LVESD) >15% were the criteria of responsiveness. The favorable clinical response (p = ns) and cardiovascular mortality (p = 0.737) was similar in the 3 groups. In the group of very old patients, a significant increase in total mortality was observed (p = 0.03). The rate of acute complications related to the procedure did not differ between the groups (p = ns).

Conclusion

The response to CRT and cardiovascular mortality were not affected by the advanced age and should not be an exclusion factor of this therapy. The procedure has been shown to be safe in elderly patients due to low rate of acute complications.

Klíčová slova:

Death rates – Echocardiography – Elderly – Geriatrics – Heart failure – Medical devices and equipment – Medical implants – Prosthetics


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 12