Elevated pulmonary artery pressure predicts poor outcome after cardiac resynchronization therapy
Jingfeng Wang1, Yangang Su, Jin Bai
1Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Shanghai, 200032, China.
Summary
Patients with elevated pulmonary artery systolic pressure (PASP) show reduced benefit from cardiac resynchronization therapy (CRT). Baseline PASP is a key predictor of long-term outcomes in heart failure patients undergoing CRT.
Area of Science:
- Cardiology
- Pulmonary Hypertension
- Heart Failure Management
Background:
- Pulmonary artery hypertension (PAH) is linked to poor prognosis in chronic heart failure (CHF).
- Limited data exists on the impact of baseline pulmonary artery systolic pressure (PASP) on outcomes after cardiac resynchronization therapy (CRT).
Purpose of the Study:
- To investigate the association between baseline PASP and CRT response in patients with CHF.
- To determine if baseline PASP predicts clinical outcomes following CRT.
Main Methods:
- Retrospective analysis of 187 patients undergoing CRT.
- Stratification into three groups based on preoperative PASP (<45 mmHg, 45-70 mmHg, ≥70 mmHg).
- Assessment of clinical, echocardiographic improvements, response rates at 6 months, and long-term prognosis (transplantation- and hospitalization-free survival).
Main Results:
- 183 patients were analyzed; mean age 60.7 years.
- Patients with PASP <45 mmHg showed significantly greater clinical improvements and response rates at 6 months compared to higher PASP groups.
- Elevated baseline PASP (≥45 mmHg) was associated with significantly higher rates of death, transplantation, and heart failure readmission post-CRT.
Conclusions:
- Patients with elevated baseline PASP experience diminished benefits from CRT.
- Baseline PASP is an independent predictor of long-term prognosis in patients receiving CRT for heart failure.
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