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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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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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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
PubMed

Insights

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.

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.
Abstract

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