Influence Of Basic Renal Function On The Clinical Efficacy Of Cardiac Resynchronzation Therapy In Patients With Chronic Heart Failure

ObjectiveTo observe the influence of different basic renal function on short and long term efficacy of cardiac resynchronization therapy to chronic heart failure patients.MethodThis study evaluated57consecutive patients who successfully underwent CRT at our hospital and have complete follow-up data. The patients were divided into three groups according to a baseline estimated glomerular filtration rate (e-GFR):group A (e-GFR<60ml/min, n=18), group B(60ml/min<e-GFR<90ml/min, n=30), group C(e-GFR≥90ml/min, n=9). Collect the baseline clinical data, operation data, and the survival situation and the echocardiographic data after operation, analysis the clinical improvement of there patients. ResultsThe mean follow-up period is33months. At the first month after CRT implantation, the average value of all the parameters were reduced. NYHA classification was significantly improved in all the three groups, LVEF was significantly improved in group A and B. At the sixth month after CRT implantation, the only improvement of group A was LVEF, while the NYHA classification, LVEDd and LVEF were improved in group B and C. After two years of CRT implantation, the NYHA classification and LVEF were improved in group A, the NYHA classification, LVEDd, LVESd and LVEF were improved in group B, and all the parameters were improved in group C. After a long-term follow-up, there is no significant differentiation of cardiac mortality among the three groups. While the cardiac mortality combined with HF hospitalization was significantly different among the three groups.ConclusionChronic HF patients with different renal function can get different efficacy of CRT. These with mild to moderate renal function decrease (CKD Ⅰ and Ⅱ) get better long-term efficacy and cardiac survival after CRT compared to those with severe renal function decrease (CKD Ⅲ and Ⅳ). CRT can also reverse ventricular remodeling greatly in the patients with mild to moderate renal function decrease (CKD Ⅰ and Ⅱ).