Effect of pulmonary artery systolic pressure on super-response and prognosis in patients after cardiac resynchronization therapy

Abstract

Objective To evaluate the impact of baseline pulmonary artery systolic pressure (PASP) on cardiac function, left ventricle reverse remodeling and clinical outcomes in patients receiving cardiac resynchronization therapy (CRT). Methods A total of 73 patients undergoing CRT in our hospital between June, 2014 and December, 2017 were enrolled in this retrospective analysis. According to baseline PASP estimated by echocardiography, the patients were divided into pulmonary artery hypertension (PAH) group (PASP≥ 50 mmHg; n=27) and non-pulmonary artery hypertension (NPAH) group (PASP 0.05). ROC curve analysis showed that PASP ≤35 mmHg was capable of predicting super-response to CRT with an area under the ROC curve of 0.709 (95%CI: 0.575-0.843, P < 0.05). The patients in PAH group had a higher incidence of combined endpoints than those in NPAH group. PAH (HR=3.64, 95%CI: 1.25-10.61, P < 0.05) and left atrial diameter (HR=1.10, 95%CI: 1.01-1.20, P < 0.05) were independent predictors for the clinical outcomes of the patients. Conclusion Patients with elevated baseline PASP have poorer improvements in cardiac function, left ventricle reverse remodeling and prognosis following CRT than those with normal PASP. A baseline PASP ≤35 mmHg is predictive of super-response to CRT, and PAH and left atrial diameter are independent predictors of the clinical outcomes following CRT.

Keywords

• cardiac resynchronization therapy
• pulmonary artery systolic pressure
• super-response
• prognosis