Preservation of renal function in response to cardiac resynchronization therapy.
BACKGROUND
Cardiac resynchronization therapy (CRT) has recently been introduced as a new option for patients with severe heart failure, but its effect on renal function remains unclear.


RESULTS
Twenty-three patients receiving CRT were studied. Responders were those who showed >0% increase in left ventricular ejection fraction after CRT by echocardiography. Clinical parameters, echocardiographic measurement, renal function, and prescriptions were examined before and 3 months after CRT, and the relationship between the response to CRT and renal function was examined. The responders had a better prognosis than the non-responders (p<0.05). There was a significant difference in the change in the estimated glomerular filtration rate between the responders and non-responders (p<0.05), even in patients with renal dysfunction before CRT (p<0.01). Prescriptions of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) were 100% in the CRT responders and 60% in the non-responders (p<0.05). Up-titration of beta-blockers could be significantly achieved in the CRT responders compared with the non-responders (p<0.05).


CONCLUSIONS
Preservation of renal function was observed in the responders to CRT, even in patients with renal dysfunction. Prescription of ACEI/ARB and up-titration of beta-blockers increased in the CRT responders. These results may contribute to the beneficial effects of CRT.
Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Shinpei
S
Kimura
Masahiro
M
Ito
Masaomi
M
Chinushi
Komei
K
Tanaka
Yasutaka
Y
Tanabe
Yukio
Y
Hosaka
Satoru
S
Komura
Shinsuke
S
Okada
Kenichi
K
Iijima
Hiroshi
H
Furushima
Koichi
K
Fuse
Masahito
M
Sato
Yoshifusa
Y
Aizawa
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D004452:Echocardiography; D004554:Electric Countershock; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000503:physiopathology*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors