Gender- and age-related outcomes of cardiac resynchronization therapy: a pilot observational study.
BACKGROUND
Cardiac resynchronization therapy (CRT) has been reported to improve clinical status and survival, and shorten hospitalization rates, in patients with heart failure (HF). However, questions remain regarding the success of CRT in different subgroups of patients with HE.


OBJECTIVE
We assessed whether CRT response was related to gender or age in patients with HE.


METHODS
In a longitudinal observational study, patients with severe HF (New York Heart Association [NYHA] class III or IV, left ventricular ejection fraction [LVEF] <or=35%, and QRS duration >120 ms with left bundle branch block configuration) were enrolled. Clinical electrophysiologic and echocardiographic evaluations were performed before, and 3 and 6 months after, CRT implantation.


RESULTS
A total of 65 Iranian patients (50 men, 15 women; mean [SD] age, 60.3 [10.3] years; baseline NYHA class, 3.1 [0.36]; QRS duration, 144 [14] ms; LVEF, 21% [7.3%]; left ventricular end-diastolic diameter (LVEDD), 6.8 [0.56] mm) were evaluated. NYHA class, QRS duration, LVEF, and LVEDD were significantly improved at 3- and 6-month follow-ups both in patients aged <or=60 years and in those aged >60 years (P < 0.001, except for aged <or=60 years after 3-month follow-up [P = 0.002]). All these parameters were significantly improved in men at 3- and 6-month follow-ups (P < 0.001). NYHA class (P = 0.002), QRS duration (P = 0.001), LVEF (P = 0.013 at 3 months and <0.001 at 6 months), and LVEDD (P = 0.007 at 3 months and <0.001 at 6 months) also were significantly improved in women. At 3- and 6-month follow-ups, there were no significant differences in improvement of these factors between the 2 age groups of patients.


CONCLUSIONS
CRT response in these patients with HF did not appear to be gender or age related at 3- and 6-month follow-ups in this small observational study. Confirmation of these findings by larger studies is needed.
Kelarijani
Ramezan Bakhshian
RB
Clinical Research Unit, Baqiyatallah University of Medical Sciences, Tehran, Iran. parsi.bakhshian@gmail.com
Saleh
Davoud Kazemi
DK
Chalian
Majid
M
Kabir
Ali
A
Ahmadzad Asl
Massoud
M
Dadjoo
Yahya
Y
D000367:Age Factors; D000368:Aged; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D010865:Pilot Projects; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume; D016896:Treatment Outcome