Prognostic effects of pulmonary hypertension in patients undergoing cardiac resynchronization therapy.

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.