Pharmacological treatment changes of chronic heart failure during cardiac resynchronization therapy: A 1-year follow-up study

Int J Cardiol. 2017 Jul 1:238:92-96. doi: 10.1016/j.ijcard.2017.03.051. Epub 2017 Mar 14.

Abstract

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.

Keywords: Cardiac resynchronization therapy; Heart failure; Medication; Pharmacological treatment.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cardiac Resynchronization Therapy / methods*
  • Cardiac Resynchronization Therapy / trends
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnostic imaging*
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists