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.
Kimura
Shinpei
S
Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Ito
Masahiro
M
Chinushi
Masaomi
M
Tanaka
Komei
K
Tanabe
Yasutaka
Y
Hosaka
Yukio
Y
Komura
Satoru
S
Okada
Shinsuke
S
Iijima
Kenichi
K
Furushima
Hiroshi
H
Fuse
Koichi
K
Sato
Masahito
M
Aizawa
Yoshifusa
Y
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