title: Prognostic effects of pulmonary hypertension in patients undergoing cardiac resynchronization therapy.
abstract: BACKGROUND
  Aim of this study is to investigate the impact of elevated pulmonary artery systolic pressure (PASP) on mortality and the clinical outcome after cardiac resynchronization therapy (CRT).
  
  
  METHODS
  Ninety-three patients with heart failure were enrolled into this study, and all of them have been treated by CRT for more than 6 months. Based on the level of preoperative PASP, they were divided into three groups (Group I: PASP>50mmHg, n=29; Group II: 30mmHg<PASP≤50mmHg, n=17; Group III: PASP≤=30mmHg, n=47). Mortality and the clinical outcome were compared among three groups in a mean follow-up period of 32.01±20.05 months.
  
  
  RESULTS
  ①Eight (28%), one (6%) and eight (17%) patients died in-group I, II and III respectively. Among those patients, 5 in group I and 1 in group III died of heart failure, while the patient in group II died of sudden death. ②In all three groups, CRT significantly improved heart function evaluated by NYHA heart function class and 6 minutes walking distance (6-MWT) (P<0.01). The improvement was more significant in group III than group I (P<0.01). ③At 3 months after CRT, Left ventricular ejection fraction (LVEF) increased significantly in Group III (P<0.01), but not in Group I or II (all P>0.05. At 6 months after CRT, LVEF increased significantly in all three groups (all P<0.05).
  
  
  CONCLUSIONS
  Elevated PASP has no prognostic effects on heart function improvement in patients undergone CRT. However, it was associated with worse LV remodeling and increased death due to aggravation of heart failure.
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang 110016, Liaoning, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Wang
authors.forename: Yaling
authors.initials: Y
authors.lastname: Han
authors.forename: Hongyun
authors.initials: H
authors.lastname: Zang
authors.forename: Haibo
authors.initials: H
authors.lastname: Yu
authors.forename: Shouli
authors.initials: S
authors.lastname: Wang
authors.forename: Zulu
authors.initials: Z
authors.lastname: Wang
authors.forename: Quanmin
authors.initials: Q
authors.lastname: Jing