Effectiveness of cardiac resynchronization therapy in heart failure patients with valvular heart disease: Comparison with patients affected by ischaemic heart disease or dilated cardiomyopathy. the InSync/InSync ICD Italian Registry

Giuseppe Boriani, Maurizio Gasparini, Maurizio Landolina, Maurizio Lunati, Mauro Biffi, Massimo Santini, Luigi Padeletti, Giulio Molon, Gianluca Botto, Tiziana De Santo, Sergio Valsecchi

Research output: Contribution to journalArticlepeer-review

Abstract

AimsTo analyse the effectiveness of cardiac resynchronization therapy (CRT) in patients with valvular heart disease (a subset not specifically investigated in randomized controlled trials) in comparison with ischaemic heart disease or dilated cardiomyopathy patients.Methods and resultsPatients enrolled in a national registry were evaluated during a median follow-up of 16 months after CRT implant. Patients with valvular heart disease treated with CRT (n = 108) in comparison with ischaemic heart disease (n = 737) and dilated cardiomyopathy (n = 635) patients presented: (i) a higher prevalence of chronic atrial fibrillation, with atrioventricular node ablation performed in around half of the cases; (ii) a similar clinical and echocardiographic profile at baseline; (iii) a similar improvement of LVEF and a similar reduction in ventricular volumes at 6-12 months; (iv) a favourable clinical response at 12 months with an improvement of the clinical composite score similar to that occurring in patients with dilated cardiomyopathy and more pronounced than that observed in patients with ischaemic heart disease; (v) a long-term outcome, in term of freedom from death or heart transplantation, similar to patients affected by ischaemic heart disease and basically more severe than that of patients affected by dilated cardiomyopathy.ConclusionIn 'real world' clinical practice, CRT appears to be effective also in patients with valvular heart disease. However, in this group of patients the outcome after CRT does not precisely overlap any of the two other groups of patients, for which much more data are currently available.

Original languageEnglish
Pages (from-to)2275-2283
Number of pages9
JournalEuropean Heart Journal
Volume30
Issue number18
DOIs
Publication statusPublished - Sep 2009

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Remodelling
  • Valvular heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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