Cardiac resynchronization therapy improves functional status and cognition

Stefano Fumagalli, Paolo Pieragnoli, Giuseppe Ricciardi, Giuseppe Mascia, Franco Mascia, Federica Michelotti, Giosuè Mascioli, Matteo Beltrami, Margherita Padeletti, Martina Nesti, Niccolò Marchionni, Luigi Padeletti

Research output: Contribution to journalArticle

Abstract

Background Many trials demonstrated the beneficial effects on hospitalizations and mortality of cardiac resynchronization therapy (CRT). The purpose of this study was to evaluate CRT effects on functional performance and cognition, two determinants of disability, frailty development and survival. Methods All consecutive patients receiving a CRT device were evaluated at baseline and at the 6-month follow-up. Functional profile was assessed with the Short Physical Performance Battery (SPPB), a measure exploring balance, gait, strength and endurance, highly predictive of incident disability and mortality. The Mini-Mental State Examination (MMSE) was used to study the cognitive profile. Results We enrolled 54 patients; two of them died during the follow-up, two refused to continue the study. Age was 67 ± 10 years (men: 80%, LVEF: 28 ± 5%); medical therapy was optimized (ACE-I/ARB: 84%, beta-blockers: 80%). After 6 months, CRT was associated with the improvement of LVEF (35 ± 8 vs. 28 ± 5%, p <0.001) and NYHA Class (1.8 ± 0.6 vs. 2.6 ± 0.5, p <0.001), and with the reduction of left ventricular end-systolic diameter (50 ± 9 vs. 57 ± 9 mm, p <0.001). SPPB improved in its total score (10.3 ± 2.0 vs. 9.1 ± 2.7, p <0.001) and in the scores exploring gait speed and strength and endurance. These changes were associated with a better cognitive profile (MMSE score: 27.0 ± 3.5 vs. 25.9 ± 4.8, p = 0.009). Advanced age was an independent predictor of improved functional performance and cognition. Conclusions CRT is associated with higher functional and cognitive profile after only 6 months of therapy. These findings let us hypothesize a powerful effect of treatment to slow disability and frailty development in heart failure.

Original languageEnglish
Pages (from-to)212-217
Number of pages6
JournalInternational Journal of Cardiology
Volume219
DOIs
Publication statusPublished - Sep 15 2016

Keywords

  • Cardiac resynchronization therapy
  • Cognitive impairment
  • Elderly
  • Frailty
  • Heart failure
  • SPPB

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Fumagalli, S., Pieragnoli, P., Ricciardi, G., Mascia, G., Mascia, F., Michelotti, F., Mascioli, G., Beltrami, M., Padeletti, M., Nesti, M., Marchionni, N., & Padeletti, L. (2016). Cardiac resynchronization therapy improves functional status and cognition. International Journal of Cardiology, 219, 212-217. https://doi.org/10.1016/j.ijcard.2016.06.001