The association of hematological indices with the response to cardiac resynchronization therapy: a single-center
G Bazoukis1, A Saplaouras1, K P Letsas1
1Second Department of Cardiology, General Hospital of Athens "Evangelismos", Athens, Greece.
Insights
Age and creatinine levels predict response to cardiac resynchronization therapy (CRT) in heart failure patients. Hematological markers did not show significant associations with CRT response.
Area of Science:
- Cardiology
- Biochemistry
- Hematology
Background:
- Cardiac resynchronization therapy (CRT) is a treatment for heart failure (HF) patients with reduced ejection fraction.
- A significant portion of patients (up to 40%) do not respond to CRT.
- Predictors of CRT response require further investigation.
Purpose of the Study:
- To investigate the association between hematological and biochemical indices and CRT response in HF patients.
- To identify factors influencing the effectiveness of CRT.
Main Methods:
- Retrospective study of 48 HF patients undergoing CRT implantation (January 2013 - November 2017).
- CRT response defined as LVEF increase ≥10% or LVESV decrease ≥15% at 6 months.
- Multivariate analysis used to identify predictors of response.
Main Results:
- 77.1% of patients responded to CRT.
- Age and creatinine levels were independent predictors of CRT response (p=0.03 and p=0.02, respectively).
- No significant associations were found between hematological markers and CRT response.
Conclusions:
- Age and creatinine levels are key predictors of CRT response.
- Hematological markers are not significantly associated with CRT response.
- Smaller improvements in LVEF and LVESV predicted ventricular tachycardia and hospitalizations.
Background:
Cardiac resynchronization therapy (CRT) is an established therapeutic option for patients with heart failure (HF) and left ventricular ejection fraction (LVEF) ≤35 % who meet specific criteria according to current guidelines. However, up to 40 % of patients have no response to CRT. Our study aimed to investigate the association between different hematological and biochemical indices and response to CRT.
Methods:
Patients with HF due to ischemic or dilated cardiomyopathy referred to our hospital for CRT implantation from January 2013 to November 2017 were included in the study. Response to CRT was defined as an increase in LVEF ≥10 % or a decrease in left ventricular end-systolic volume (LVESV) ≥15 % at six months of follow-up.
Results:
A total of 48 patients (mean age: 66.2 ± 9.5 years, 81.3 % males) were included in the study. Of these HF patients, 29 (60.4 %) had ischemic cardiomyopathy, and 19 (39.6 %) had dilated cardiomyopathy. At six months of follow-up, 37 patients (77.1 %) had responded to CRT. Ten patients (20.8 %) had ventricular tachycardia (VT), 24 (50 %) patients were hospitalized, and two patients (4.2 %) died during the follow-up period. Multivariate analysis demonstrated that age (p =0.03) and creatinine levels (p =0.02) were independent predictors of the response to CRT. No significant associations between hematological markers (white blood cells, neutrophils, lymphocytes, platelets, neutrophil to lymphocyte ratio, red blood cells distribution width) and CRT response were observed.
Conclusions:
A smaller increase in LVEF and a smaller decrease in LVESV were predictive for VT occurrence and hospitalizations in patients receiving CRT. No significant association between hematological markers and response to CRT was found. HIPPOKRATIA 2019, 23(3): 118-125.
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