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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
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M. Cardiovascular Nursing
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Which variables can predict prognosis in heart failure patients after cardiac resynchronization?
Session:
Posters 3 - Écran 06 - IC - Prognóstico
Speaker:
Tiago Mendonça
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.3 Cardiac Resynchronization Therapy
Session Type:
Posters
FP Number:
---
Authors:
Tiago Mendonça; Ana Abreu; Dra. Inês Rodrigues; Guilherme Portugal; Pedro Rio; Helena Santa Clara; Vanessa Santos; Pedro Silva Cunha; Mário Martins Oliveira; Rui M. Soares; Miguel Mota Carmo; Sofia Silva; Rui Cruz Ferreira
Abstract
<p><strong>Introduction:</strong> Cardiac resynchronization therapy (CRT) is an established nonpharmacological treatment targeting a better prognosis in selected heart failure (HF) patients. Our purpose was to evaluate which parameters after CRT could predict cardiac events.</p> <p><strong>Methods:</strong> We prospectively evaluated HF patients who were referred to CRT. All patients performed clinical and laboratory evaluation, echocardiogram and cardiopulmonary exercise test (CPET) just before and 6 months (6M) after CRT. Cardiac events (hospitalization, mortality and cardiac transplant) were evaluated.</p> <p><strong>Results:</strong> 112 HF patients, 68.8% male, mean age 69.5±13 years, 53.6% ischemic, 74.5% in class III-IV NYHA, mean left ventricular ejection fraction (LVEF) 26.3±6.8%, mean BNP 522.3±555.3 pg/mL were included in this observational study. At 6M 74.1% patients were class I-II NYHA, mean LVEF 37.52±11.1% and mean BNP 413.2±537.9 pg/mL. 15 deaths, 23 hospitalization for HF decompensation and 1 cardiac transplant occurred during follow up (mean time 25.09±12.7 months). Hospitalization for HF was inversely correlated with 6M LVEF (p=0.001), and directly correlated with 6M BNP level (p=0.004), baseline and 6M VE/VO2 slope (p=0.024 and p=0.036, respectively). Independent predictors of HF hospitalization in multivariate analysis were 6M LVEF (OR 0.899, 95% IC 0.809-0.999, p=0.05) and VE/VCO2 slope at 6M (OR 1.207, 95% IC 1.001-1.462, p=0.05). 6M BNP levels was the only independent predictor of mortality or cardiac transplant in multivariate analysis (p=0.012). None of the evaluated parameters before CRT predicted events in this group of patients.</p> <p><strong>Conclusions:</strong> Hospitalization for HF was predicted by LVEF and VE/VCO2 slope, and mortality or cardiac transplant by BNP, at 25 months follow up after CRT. Besides the echocardiogram and BNP measurement, CPET was demonstrated to be fundamental in the follow-up of these patients and should be performed at 6 months for prognostic purposes.</p>
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