title: Pharmacological treatment changes of chronic heart failure during cardiac resynchronization therapy: A 1-year follow-up study.
abstract: BACKGROUND
  Cardiac resynchronization therapy (CRT) is associated with improved morbidity and mortality in patients with chronic heart failure (HF) on optimal medical therapy. We aimed to evaluate changes of medical therapy during CRT and its influence on the CRT response.
  
  
  METHODS
  We evaluated 85 HF patients' pharmacological treatment changes during 1-year follow-up of CRT. Statistical analysis was performed using IBM SPSS statistical software (SPSS v.21.0 for Mac OS X).
  
  
  RESULTS
  Beta-blockers (BAB) were used in 81.2% of patients before CRT, and consumption increased after CRT implantation (96.5% at 1-year follow-up visit) (p<0.002). Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) consumption and dose didn't significantly change statistically during the study. 55.3% of patients were taking spironolactone before CRT, and this number increased at discharge till 76.5% (p<0.001) and till 70.6% (p=0.01) at 1-year follow-up visit. The average dose of spironolactone during the study significantly decreased statistically. The use of diuretics was higher after CRT device implantation, compared with the period before CRT 80% to 84.7% (p<0.001), but torasemide dose hadn't significantly changed statistically and remained almost the same. Cardiovascular medication consumption was significantly lower before CRT, compared with discharge (p<0.001) and follow-up (p<0.001) periods. However, no statistically significant relation between pharmacological treatment and echocardiographic response was found.
  
  
  CONCLUSIONS
  The present study confirmed that pharmacological treatment has changed during the period before and after CRT. But no statistically significant relation between pharmacological treatment and echocardiographic response was found.
authors.affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania; Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania. Electronic address: diana.rinkuniene@gmail.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Rinkuniene
authors.affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania; Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
authors.forename: Ausra
authors.initials: A
authors.lastname: Krivickiene
authors.affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania; Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Laukaitiene
authors.affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania; Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
authors.forename: Renaldas
authors.initials: R
authors.lastname: Jurkevicius
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D058406:Cardiac Resynchronization Therapy / Q000379:methods* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists
keywords: Cardiac resynchronization therapy; Heart failure; Medication; Pharmacological treatment