Frailty and long-term survival in patients undergoing cardiac resynchronization therapy
https://doi.org/10.29001/2073-8552-2022-488
Abstract
Aim: To access frailty and its impact on 10-year survival in patients with implanted devices for cardiac resynchronization therapy (CRT).
Methods: 77 patients with congestive heart failure (74% men, 26% women; mean age of 58.7 ± 10.7 years) with NYHA class II–IV were enrolled. Frailty Index was calculated using 31 parameters (the ability to perform daily activities, clinical status, laboratory markers, comorbidities). Based on the frailty index patients were identified as not frail (< 0.375; n = 41; 53%), and frail (≥ 0.375; n = 36; 47%).
Results: The mean follow-up period was 49.0 ± 34.2 months. Survival at 10-year follow-up was 87.5% for non-frail patients, compared to 47.2% for frail patients (log-rank test p < 0.001). In univariate analysis, frailty associated with 10-year mortality (OR 7.824; 95% CI 2.495 – 24.533; p < 0.001). After adjustment for age, gender, rhythm, NYHA class, left ventricular ejection fraction, left bundle branch block, and QRS width, frailty remained a significant prognostic factor associated with 10-year mortality (OR 9.528; 95% CI 2.720 – 33.368; p < 0.001). Also, according to logistic regression, the presence of frailty reduced the chance of superresponse (decrease of left-ventricular end -systolic volume ≥ 30%) to CRT (OR 0.278; 95% CI 0.100–0.770; p = 0.014).
Conclusion: Frailty is widespread in patients with heart failure and implanted devices for CRT. In these patients frailty is associated with a more than seven-fold increased risk of death during 10-year follow-up and with a lower chance of superresponse to CRT.
About the Authors
A. M. Soldatova
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences (Tyumen Cardiology Research Center, Tomsk NRMC)
Russian Federation
Russian Federation
Anna M. Soldatova, Dr. Sci. (Med.), Research Scientist, Laboratory of Instrumental Diagnostics of the Scientific Division of Instrumental Research Methods
111, Melnikaite str., Tyumen, 625026
T. N. Enina
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences (Tyumen Cardiology Research Center, Tomsk NRMC)
Russian Federation
Russian Federation
Tatiana N. Enina, Dr. Sci. (Med.), Leading Research Scientist, Arterial Hypertension and Coronary Insufficiency Department of the Scientific Division of Clinical Cardiology
111, Melnikaite str., Tyumen, 625026
D. S. Malishevskaia
International Heart Center
Russian Federation
Russian Federation
Diana S. Malishevskaia, Cardiologist
6, Tverskaya str., Saint-Petersburg, 191015
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Review
For citations:
Soldatova A.M., Enina T.N., Malishevskaia D.S. Frailty and long-term survival in patients undergoing cardiac resynchronization therapy. Siberian Journal of Clinical and Experimental Medicine. https://doi.org/10.29001/2073-8552-2022-488
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