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Pharmacological treatment changes of chronic heart failure during cardiac resynchronization therapy: A 1-year
Diana Rinkuniene1, Ausra Krivickiene1, Jolanta Laukaitiene1
1Lithuanian University of Health Sciences, Kaunas, Lithuania; Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
Insights
Cardiac resynchronization therapy (CRT) changes medical therapy, increasing beta-blocker and spironolactone use. However, these medication adjustments did not significantly impact CRT response in heart failure patients.
Area of Science:
- Cardiology
- Pharmacology
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) improves outcomes in chronic heart failure (HF) patients on optimal medical therapy.
- Understanding medication changes during CRT is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate changes in pharmacological treatment during CRT.
- To determine the influence of these medication changes on CRT response.
Main Methods:
- Retrospective evaluation of 85 HF patients' medication regimens over 1-year follow-up post-CRT.
- Statistical analysis using SPSS software.
Main Results:
- Increased use of beta-blockers (81.2% to 96.5%) and spironolactone (55.3% to 76.5%) post-CRT.
- No significant changes in ACE inhibitors/ARBs; spironolactone dose decreased.
- Diuretic use increased (80% to 84.7%), but torasemide dose remained stable.
- Overall cardiovascular medication use increased significantly post-CRT.
- No statistically significant correlation found between medication changes and echocardiographic CRT response.
Conclusions:
- Pharmacological treatment regimens are modified before and after CRT implantation.
- Current medication adjustments during CRT did not demonstrate a statistically significant relationship with echocardiographic response.
Background:
Cardiac resynchronization therapy (CRT) is associated with improved morbidity and mortality in patients with chronic heart failure (HF) on optimal medical therapy. We aimed to evaluate changes of medical therapy during CRT and its influence on the CRT response.
Methods:
We evaluated 85 HF patients' pharmacological treatment changes during 1-year follow-up of CRT. Statistical analysis was performed using IBM SPSS statistical software (SPSS v.21.0 for Mac OS X).
Results:
Beta-blockers (BAB) were used in 81.2% of patients before CRT, and consumption increased after CRT implantation (96.5% at 1-year follow-up visit) (p<0.002). Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) consumption and dose didn't significantly change statistically during the study. 55.3% of patients were taking spironolactone before CRT, and this number increased at discharge till 76.5% (p<0.001) and till 70.6% (p=0.01) at 1-year follow-up visit. The average dose of spironolactone during the study significantly decreased statistically. The use of diuretics was higher after CRT device implantation, compared with the period before CRT 80% to 84.7% (p<0.001), but torasemide dose hadn't significantly changed statistically and remained almost the same. Cardiovascular medication consumption was significantly lower before CRT, compared with discharge (p<0.001) and follow-up (p<0.001) periods. However, no statistically significant relation between pharmacological treatment and echocardiographic response was found.
Conclusions:
The present study confirmed that pharmacological treatment has changed during the period before and after CRT. But no statistically significant relation between pharmacological treatment and echocardiographic response was found.