SPC365

Impact of low hemoglobin values in CRT response

Session: SESSÃO DE POSTERS 49 - RESSINCRONIZAÇÃO CARDÍACA E TERAPÊUTICA MÉDICA
Speaker: Luís Sousa Azevedo

Congress: CPC 2025
Topic: C. Arrhythmias and Device Therapy
Theme: 09. Device Therapy
Subtheme: 09.3 Cardiac Resynchronization Therapy
Session Type: Cartazes
FP Number: ---
Authors: Luís Sousa Azevedo; Marta Bernardo; Isabel Martins Moreira; Isabel Nóbrega Fernandes; Pedro Mateus; José Pedro Guimarães; Renato Margato; Paulo Fontes; Sílvia Leão; Ilídio Moreira

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Introduction: Heart failure (HF) is a complex condition frequently accompanied by comorbidities such as anemia, which is independently linked to worse outcomes in affected patients. Among individuals with HF who are candidates for Cardiac Resynchronization Therapy (CRT), the presence of anemia may influence the effectiveness of this treatment, potentially reducing its therapeutic benefits.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Objective: We aimed to assess whether pre-implantation low hemoglobin levels affect the response to Cardiac Resynchronization Therapy (CRT).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Methods: This is an observational, retrospective study that included patients who underwent CRT device implantation between January 2017 and March 2024. Out of a total population of 201 patients, we included those who had at least one year of follow-up and met the evaluation criteria required for this study at that time.&nbsp;</span></span></span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">We classified patients as responders or non-responders based on their response to CRT. In this study, CRT response was considered positive if a reduction of at least 15% in left ventricular end-systolic volume at one-year follow-up occured. Anemia was defined as a hemoglobin level below 12 g/dL.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Differences between groups were assessed using Chi-square analysis for categorical variables and the median comparison test for numerical variables. The influence of each variable on the response to CRT was evaluated using binary logistic regression.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Results: This analysis included 86 patients, of whom 66.7% were male, with a median age of 76 years (range: 69&ndash;81) and a median hemoglobin level of 13 g/dL (range: 11.33&ndash;14.33). Responders comprised 64% of the study population. A comparison of responders and non-responders is presented in Table 1. Factors associated with a poorer response included male gender (p=0.03), atrial fibrillation (p=0.04), chronic kidney disease (CKD) (p=0.02), and anemia (p=0.03), while a history of left bundle branch block was linked to a better response (p=0.003).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Binary logistic regression identified anemia as a significant predictor of non-response to CRT, with an odds ratio of 8.543 (95% CI: 1.768&ndash;41.292; p=0.008). Further details are provided in Table 2.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Conclusion: In this study, hemoglobin levels below 12 g/dL were linked to a poorer response to CRT, measured by cardiac reverse remodelling. Addressing anemia and correcting reversible causes could potentially enhance long-term CRT response. However, larger studies are needed to define more precise clinical targets.</span></span></span></span></p>

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