194 Cardiac resynchronization therapy in elderly patients

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• 作者：A. Rollin-Garderes¹ ; A. Duparc¹ ; P. Mondoly¹ ; N. Combes² ; A. Hebrard¹ ; M. Delay¹ ; Ph. Maury¹ ; Jp. Albenque¹ ; Didier Carri&eacute ; ¹ ; S. Boveda²
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：3
• 期：1
• 页码：63
• 全文大小：46 K

文摘

ass=""h4"">Background

Cardiac Resynchronization Therapy (CRT) improves morbidity and mortality in systolic heart failure. Elderly patients are under represented in large clinical trials although incidence of heart failure is high in this population.

ass=""h4"">Method

we considered 146 consecutive patients 75 years old with standard indication for CRT implanted between 2005 and 2007. Mean age was 79 yo, 72 % males, EF = 27 % , ischemic heart disease (IHD) 46 % , Atrial Fibrillation 54 % , CRT-D: 16 % . Minimal follow-up was 12 months. Total mortality, clinical improvement (gain > 1 NYHA class without hospitalization for congestive heart failure) and combined criteria (mortality and clinical improvement) were retrospectively assessed.

ass=""h4"">Results

Mean follow-up is 25 +/-12 months. Data are complete for 137 patients (94.2 % ).

Survival rate is 65 % , clinical improvement is achieved in 51 % and combined criteria in 45 % .

Independent factors of non response (p<0.10) are summarized in the table.

Causes of deaths are: terminal heart failure: 35 pts, sudden cardiac death: 1 pt, non cardiac death: 13 pts and unknown: 2 pts.

ass=""h4"">Conclusion

able class=""dataTable"" frame=""hsides"" border=""0"" cellpadding=""0"" rules=""groups"" cellspacing=""0"">an=""4"">ad>align=""left"">Multivariate analysis OR (IC 95 % )align=""center"">Combined criteriaalign=""center"">Total Mortalityalign=""center"">Clinical improvementad>align=""left"">NYHA IValign=""center"">4,1 (1.5?2.4)align=""center"">3.1 (1.2?.5)align=""center"">2.5 (1?.6)align=""left"">IHDalign=""center"">2,2 (1?.8)align=""center"">3.4 (1.5?.9)align=""center"">NSalign=""left"">CRT-Dalign=""center"">NSalign=""center"">3.2 (1.2?.8)align=""center"">NSalign=""left"">Atrial fibrillationalign=""center"">2,7 (1.3?.8)align=""center"">2.2 (1?.1)align=""center"">NSalign=""left"">No ACEI/ARBalign=""center"">2,7 (0.9?.8)align=""center"">NSalign=""center"">NSalign=""left"">Renal failure (creatinine > 10¦Ìm/l)align=""center"">1,1 (1?.2)align=""center"">NSalign=""center"">1.2 (1.1?.3)align=""left"">Doses of diureticsalign=""center"">NSalign=""center"">1.03 (1?.1)align=""center"">NSable>