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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Association Between Systemic Immune-Inflammation Index and Cardiac Resynchronization Therapy Response in Patients

Abdulcebbar Şipal1, Şükriye Ebru Önder1, Serdar Bozyel1

  • 1Department of Cardiology, Health Sciences University, Kocaeli City Hospital, Kocaeli, Türkiye.

Anatolian Journal of Cardiology
|April 15, 2026
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Summary

Elevated systemic immune-inflammation index (SII) is linked to poor response to cardiac resynchronization therapy (CRT) in heart failure patients. Higher baseline SII and persistent inflammation indicate a less favorable outcome for CRT effectiveness.

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Area of Science:

  • Cardiology
  • Inflammation Research
  • Biomarker Discovery

Background:

  • Cardiac resynchronization therapy (CRT) benefits selected heart failure (HF) patients, but many do not respond.
  • Systemic inflammation may negatively impact myocardial remodeling and CRT response.
  • The systemic immune-inflammation index (SII) warrants investigation as a predictor of CRT response.

Purpose of the Study:

  • To investigate the association between the systemic immune-inflammation index (SII) and response to cardiac resynchronization therapy (CRT) in heart failure patients.
  • To determine if SII can predict clinical and echocardiographic outcomes following CRT.
  • To explore the role of inflammation in CRT nonresponse.

Main Methods:

  • Retrospective single-center study of 110 HF patients undergoing CRT.
  • Assessment of clinical, echocardiographic, and laboratory parameters, including SII, at baseline and 6-month follow-up.
  • CRT response defined by combined echocardiographic and clinical criteria; statistical analysis of inflammatory markers and CRT response.

Main Results:

  • Nonresponders had significantly higher baseline SII levels than responders.
  • SII levels increased in nonresponders but remained stable in responders during follow-up.
  • Elevated baseline SII and chronic ischemic heart disease were independent predictors of CRT nonresponse.

Conclusions:

  • Elevated SII is associated with increased likelihood of CRT nonresponse and ongoing inflammation.
  • SII may reflect an unfavorable inflammatory state impacting CRT efficacy, rather than a direct cause.
  • The systemic immune-inflammation index shows potential as a complementary biomarker for risk stratification in patients receiving CRT.