Women with nonischemic cardiomyopathy have a favorable prognosis and a better left ventricular remodeling than men after cardiac resynchronization therapy

Manlio Cipriani, Maurizio Eugenio Landolina, Fabrizio Oliva, Stefano Ghio, Sara Vargiu, Roberto Rordorf, Claudia Raineri, Enrico Ammirati, Barbara Petracci, Claudia Campo, Silvia Bisetti, M. Lunati

Research output: Contribution to journalArticle

Abstract

Aims Cardiac resynchronization therapy (CRT) is a well established therapy in heart failure patients who are on optimal medical therapy and have reduced left ventricular ejection fraction (LVEF) and wide QRS complexes. Although women and patients with nonischemic cardiomyopathy are under-represented in CRT trials and registries, there is evidence that these two groups of patients can benefit more from CRT. The aim of our analysis was to investigate the impact of female sex on mortality in a population that included a high percentage of patients (61%) with nonischemic cardiomyopathy. Methods We analyzed data on 507 consecutive patients (20% women) who received CRT at two Italian Heart Transplant centers and were followed up for a maximum of 48 months. Results After multivariate adjustment, women showed a trend toward better survival with regard to all-cause mortality [hazard ratio (HR) 0.32, confidence interval (CI) 0.10-1.04; PU0.059]. However, this benefit was limited to nonischemic patients with regard to all-cause mortality (HR 0.20, CI 0.05-0.87, PU0.032) and cardiovascular mortality (HR 0.14, CI 0.02-1.05, PU0.056). Conclusion Female CRT recipients, at mid-term, have a favorable prognosis than male patients and this benefit appears to be more evident in nonischemic patients. Thus, we strongly believe that the apparent under-utilization of CRT in females is an anomaly that should be corrected.

Original languageEnglish
Pages (from-to)291-298
Number of pages8
JournalJournal of Cardiovascular Medicine
Volume17
Issue number4
DOIs
Publication statusPublished - 2016

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Cardiac Resynchronization Therapy
Ventricular Remodeling
Cardiomyopathies
Mortality
Confidence Intervals
Stroke Volume
Registries
Heart Failure
Transplants
Survival
Therapeutics

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Outcome
  • Sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Women with nonischemic cardiomyopathy have a favorable prognosis and a better left ventricular remodeling than men after cardiac resynchronization therapy. / Cipriani, Manlio; Landolina, Maurizio Eugenio; Oliva, Fabrizio; Ghio, Stefano; Vargiu, Sara; Rordorf, Roberto; Raineri, Claudia; Ammirati, Enrico; Petracci, Barbara; Campo, Claudia; Bisetti, Silvia; Lunati, M.

In: Journal of Cardiovascular Medicine, Vol. 17, No. 4, 2016, p. 291-298.

Research output: Contribution to journalArticle

Cipriani, Manlio ; Landolina, Maurizio Eugenio ; Oliva, Fabrizio ; Ghio, Stefano ; Vargiu, Sara ; Rordorf, Roberto ; Raineri, Claudia ; Ammirati, Enrico ; Petracci, Barbara ; Campo, Claudia ; Bisetti, Silvia ; Lunati, M. / Women with nonischemic cardiomyopathy have a favorable prognosis and a better left ventricular remodeling than men after cardiac resynchronization therapy. In: Journal of Cardiovascular Medicine. 2016 ; Vol. 17, No. 4. pp. 291-298.
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AU - Cipriani, Manlio

AU - Landolina, Maurizio Eugenio

AU - Oliva, Fabrizio

AU - Ghio, Stefano

AU - Vargiu, Sara

AU - Rordorf, Roberto

AU - Raineri, Claudia

AU - Ammirati, Enrico

AU - Petracci, Barbara

AU - Campo, Claudia

AU - Bisetti, Silvia

AU - Lunati, M.

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N2 - Aims Cardiac resynchronization therapy (CRT) is a well established therapy in heart failure patients who are on optimal medical therapy and have reduced left ventricular ejection fraction (LVEF) and wide QRS complexes. Although women and patients with nonischemic cardiomyopathy are under-represented in CRT trials and registries, there is evidence that these two groups of patients can benefit more from CRT. The aim of our analysis was to investigate the impact of female sex on mortality in a population that included a high percentage of patients (61%) with nonischemic cardiomyopathy. Methods We analyzed data on 507 consecutive patients (20% women) who received CRT at two Italian Heart Transplant centers and were followed up for a maximum of 48 months. Results After multivariate adjustment, women showed a trend toward better survival with regard to all-cause mortality [hazard ratio (HR) 0.32, confidence interval (CI) 0.10-1.04; PU0.059]. However, this benefit was limited to nonischemic patients with regard to all-cause mortality (HR 0.20, CI 0.05-0.87, PU0.032) and cardiovascular mortality (HR 0.14, CI 0.02-1.05, PU0.056). Conclusion Female CRT recipients, at mid-term, have a favorable prognosis than male patients and this benefit appears to be more evident in nonischemic patients. Thus, we strongly believe that the apparent under-utilization of CRT in females is an anomaly that should be corrected.

AB - Aims Cardiac resynchronization therapy (CRT) is a well established therapy in heart failure patients who are on optimal medical therapy and have reduced left ventricular ejection fraction (LVEF) and wide QRS complexes. Although women and patients with nonischemic cardiomyopathy are under-represented in CRT trials and registries, there is evidence that these two groups of patients can benefit more from CRT. The aim of our analysis was to investigate the impact of female sex on mortality in a population that included a high percentage of patients (61%) with nonischemic cardiomyopathy. Methods We analyzed data on 507 consecutive patients (20% women) who received CRT at two Italian Heart Transplant centers and were followed up for a maximum of 48 months. Results After multivariate adjustment, women showed a trend toward better survival with regard to all-cause mortality [hazard ratio (HR) 0.32, confidence interval (CI) 0.10-1.04; PU0.059]. However, this benefit was limited to nonischemic patients with regard to all-cause mortality (HR 0.20, CI 0.05-0.87, PU0.032) and cardiovascular mortality (HR 0.14, CI 0.02-1.05, PU0.056). Conclusion Female CRT recipients, at mid-term, have a favorable prognosis than male patients and this benefit appears to be more evident in nonischemic patients. Thus, we strongly believe that the apparent under-utilization of CRT in females is an anomaly that should be corrected.

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