title: Functional and clinical implications of cardiac resynchronization therapy on outcomes of diabetic patients with heart failure.
abstract: OBJECTIVE
  To compare functional and structural changes of the left ventricle and long-term clinical outcomes in diabetic and nondiabetic patients with heart failure undergoing cardiac resynchronization therapy (CRT).
  
  
  METHODS
  Sixty-eight patients with heart failure undergoing CRT were included: 18 were diabetic patients and 50 nondiabetic patients. The CRT eligibility was established by echocardiographic assessments.
  
  
  RESULTS
  CRT improved ventricular geometry and dyssynchrony in both diabetic and nondiabetic patients, with no significant difference in the magnitude of the effects on the left ventricular function. Over a median follow-up of 30.6 ± 6.2 months, there were no significant differences in the rates of any cause death (16.7 vs. 14.0%, P = 0.72), cardiac death (11.1 vs. 8.0%, P = 0.65) and heart rehospitalization (5.6 vs. 6.0%, P = 1.0), between diabetic and nondiabetic patients, respectively. Diabetes was not found to be an independent factor associated with worse clinical outcome.
  
  
  CONCLUSIONS
  Resynchronization therapy provided significant functional and hemodynamic improvements in both diabetic and nondiabetic patients. Long-term prognosis in heart failure patients with diabetes was comparable with that in those without diabetes.
authors.affiliation: Electrophysiology Unit, Cardiology Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Santangelo
authors.forename: Daniela
authors.initials: D
authors.lastname: Dugo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mulè
authors.forename: Euglena
authors.initials: E
authors.lastname: Puzzangara
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Schillaci
authors.forename: Salvatore
authors.initials: S
authors.lastname: Timineri
authors.forename: Piera
authors.initials: P
authors.lastname: Capranzano
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Grazia
authors.forename: Claudio
authors.initials: C
authors.lastname: Liotta
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scandura
authors.forename: Antonio
authors.initials: A
authors.lastname: Ragusa
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Valeria
authors.initials: V
authors.lastname: Calvi
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy; D048909:Diabetes Complications; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D016277:Ventricular Function, Left