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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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05. Atrial Fibrillation
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Abstract
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Vídeo
Report
CLEAR FILTERS
Clinical correlates and predictive value of high left ventricular filling pressures in CRT patients
Session:
Posters 4 - Écran 04 - Insuficiência Cardíaca
Speaker:
Maria Trêpa
Congress:
CPC 2018
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Maria Trêpa; Mário Silva Santos; Bruno Miguel Martins Bragança; Raquel Baggen Santos; Marta Fontes Oliveira; Inês Silveira; Vasco Alves Dias; Carla Roque; António Hipólito Reis; Severo Torres
Abstract
<p>Introduction</p> <p>Left ventricular filling pressure (LVFP) is an important determinant of congestion, a typical feature with prognostic value in heart failure (HF). We aimed to study the predictive value of LVFP, assessed by transthoracic echocardiography, in HF patients undergoing cardiac resynchronization therapy (CRT).</p> <p>Methods</p> <p>We retrospectively analyzed echocardiographic data of patients before CRT implantation at our center. LVFP were estimated by echocardiography and defined as having at least 2 out of 3 positive: E/e’ ratio > 14; triscupid regurgitation velocity > 2.8 m/s or indexed atrial volume > 34ml/m2. Response to CRT was defined by a ≥5% increase in left ventricular ejection fraction (LVEF) 6-12 months after implantation. Multivariate regression models were used to assess independent predictors.</p> <p>Results</p> <p>125 patients were included of whom 57 patients (53%) met criteria for high LVFP. Patients with higher LVFP were more likely to be diabetic (46% vs 63%, p=0.064), have atrial fibrillation (40 vs 72%, p<0.01), chronic kidney disease (41% vs 69%, p=0.002) and right ventricular dysfunction (45 vs 74%, p=0.023). There was no significant differences between sex, age, etiology (ischemic vs non-ischemic) or QRS duration.</p> <p>Patients with higher LVFP are less likely to respond to CRT (70% vs 42% p=0.019) and have significantly higher NT-proBNP levels (log NT-proBNP mean 7 vs 8.4, p< 0.001). After adjusting for age and sex, high LVFP was an independent predictor of poor CRT response (OR 0.3, 95%CI 0.1-0.8, p=0.02).</p> <p>Conclusion</p> <p>Left ventricular filling pressures seem to be a useful non-invasive parameter in CRT patients since they influence response to resynchronization and correlate with a robust prognostic marker, such as NT-ProBNP. </p>
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