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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Influence of diabetes on left ventricular systolic and diastolic function and on long-term outcome after cardiac

Ulas Höke1, Joep Thijssen, Rutger J van Bommel

  • 1Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.

Diabetes Care
|December 11, 2012
PubMed

Insights

Diabetic patients show less improvement in heart function after cardiac resynchronization therapy (CRT) and have worse long-term outcomes. Diabetes independently predicts mortality in heart failure patients receiving CRT.

Area of Science:

  • Cardiology
  • Diabetology
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) effectiveness in diabetic heart failure patients is not well understood.
  • Assessing the impact of diabetes on CRT outcomes is crucial for personalized treatment.

Purpose of the Study:

  • To evaluate changes in left ventricular (LV) systolic and diastolic function in CRT recipients with and without diabetes.
  • To assess the long-term prognosis of diabetic patients undergoing CRT.

Main Methods:

  • A registry study included 710 CRT recipients (171 with diabetes).
  • Echocardiography assessed LV function at baseline and 6 months.
  • Response to CRT defined as ≥15% reduction in LV end-systolic volume (LVESV).
  • Long-term follow-up recorded all-cause mortality and cardiac events.

Main Results:

  • Diabetic patients had a lower CRT response rate (45% vs. 57%) and less pronounced LV diastolic function improvement.
  • Diabetes, LV dyssynchrony, ischemic cardiomyopathy, and insulin use were key factors in diabetic CRT response.
  • Diabetic patients experienced significantly higher rates of mortality and cardiac events (P < 0.001).
  • Diabetes independently predicted all-cause mortality, along with other factors like LVESV and diastolic dysfunction.

Conclusions:

  • Diabetic heart failure patients benefit from CRT with improved LV function, but less so than non-diabetics.
  • Diabetes is an independent predictor of mortality in CRT recipients.
Abstract

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