Fukushima journal of medical science · 2026
The prognostic significance of pharmacological therapy after cardiac resynchronization therapy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sato Takamasa, Murota Sadahiro, Nodera Minoru, Yamada Shinya, Kaneshiro Takashi, Ishida Takafumi, Takeishi Yasuchika
Аннотация
BACKGROUND: Pharmacological therapy is essential in heart failure with reduced ejection fraction (HFrEF), but its prognostic role at the time of cardiac resynchronization therapy (CRT) remains uncertain.
METHODS: We retrospectively studied 272 patients (mean age 66 years;72% male) who underwent CRT between 2005 and 2023. Pharmacological therapy was assessed only at baseline. Medication included β-blockers (97.4%), renin-angiotensin system inhibitors or angiotensin receptor-neprilysin inhibitors (RAS inhibitors/ARNIs, 81.3%), mineralocorticoid receptor antagonists (64.7%), and loop diuretics (76.8%). The primary outcome was cardiac death or left ventricular assist device (LVAD) implantation. Cox models evaluated associations between baseline medication use, medication doses, and outcomes.
RESULTS: During a median follow-up of 4.2 years, 126 patients (46.3%) experienced the primary outcome. Baseline use and higher β-blocker dose were independently associated with a lower risk of the primary outcome. RAS inhibitors/ARNIs use was also associated with a lower risk of cardiac death or LVAD implantation. In contrast, higher loop diuretic dose and inotrope use tended to be associated with worse outcomes.
CONCLUSION: Baseline use and dosing of β-blockers and RAS inhibitors/ARNIs were prognostically significant in CRT recipients, underscoring the importance of optimizing pharmacotherapy at the time of device implantation.
METHODS: We retrospectively studied 272 patients (mean age 66 years;72% male) who underwent CRT between 2005 and 2023. Pharmacological therapy was assessed only at baseline. Medication included β-blockers (97.4%), renin-angiotensin system inhibitors or angiotensin receptor-neprilysin inhibitors (RAS inhibitors/ARNIs, 81.3%), mineralocorticoid receptor antagonists (64.7%), and loop diuretics (76.8%). The primary outcome was cardiac death or left ventricular assist device (LVAD) implantation. Cox models evaluated associations between baseline medication use, medication doses, and outcomes.
RESULTS: During a median follow-up of 4.2 years, 126 patients (46.3%) experienced the primary outcome. Baseline use and higher β-blocker dose were independently associated with a lower risk of the primary outcome. RAS inhibitors/ARNIs use was also associated with a lower risk of cardiac death or LVAD implantation. In contrast, higher loop diuretic dose and inotrope use tended to be associated with worse outcomes.
CONCLUSION: Baseline use and dosing of β-blockers and RAS inhibitors/ARNIs were prognostically significant in CRT recipients, underscoring the importance of optimizing pharmacotherapy at the time of device implantation.