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Heart and Vessels

, Volume 34, Issue 5, pp 763–770 | Cite as

Assessment of coronary flow reserve predicts long-term outcome of responders to cardiac resynchronization therapy

  • Kunio YufuEmail author
  • Hidekazu Kondo
  • Tetsuji Shinohara
  • Yumi Ishii
  • Seiichiro Yoshimura
  • Ichitaro Abe
  • Shotaro Saito
  • Akira Fukui
  • Norihiro Okada
  • Hidefumi Akioka
  • Yasushi Teshima
  • Mikiko Nakagawa
  • Naohiko Takahashi
Original Article
  • 31 Downloads

Abstract

Cardiac resynchronization therapy (CRT) has been established as a treatment for patients with chronic heart failure (HF). We tested the hypothesis that assessment of coronary flow reserve (CFR) predicts the long-term outcome of CRT. The study consisted of 114 HF patients implanted with a CRT device for the treatment of advanced HF between April 2010 and April 2018. After excluding patients that withdrew from long-term follow-up and patients missing a baseline CFR measurement, we enrolled 53 eligible patients. CFR was determined non-invasively by transthoracic echocardiography. Based on the ROC curve for predicting the appearance of major adverse cerebral and cardiovascular events (MACCE), the level of preserved CFR was set at >1.35 in responders. Accurate follow-up information (mean 873 ± 498 days) was obtained in 23 patients with a preserved CFR (16 females; mean age 71 ± 7.9 years) and 11 patients with a depressed CFR (5 females; mean age, 73 ± 7.6 years) in responders. Kaplan–Meier survival analysis demonstrated that the depressed CFR group had a higher prevalence of MACCE than the preserved CFR group (log rank, 9.83; p = 0.0021). Multivariate analysis revealed that depressed CFR was associated with MACCE (hazard ratio 4.88, 95% confidence interval 1.13–26.5, p = 0.0329). Our results suggest that the assessment of CFR predicts the outcome in responders to CRT. Preservation of coronary circulation flow might underlie one of the mechanisms for a better response to CRT in responders.

Keywords

Coronary flow reserve Cardiac resynchronization therapy Long-term outcome Responder 

Notes

Funding

There was no financial support for the present study.

Compliance with ethical standards

Conflict of interest

The authors have no financial conflicts of interest to disclose.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Kunio Yufu
    • 1
    Email author
  • Hidekazu Kondo
    • 1
  • Tetsuji Shinohara
    • 1
  • Yumi Ishii
    • 1
  • Seiichiro Yoshimura
    • 1
  • Ichitaro Abe
    • 1
  • Shotaro Saito
    • 1
  • Akira Fukui
    • 1
  • Norihiro Okada
    • 1
  • Hidefumi Akioka
    • 1
  • Yasushi Teshima
    • 1
  • Mikiko Nakagawa
    • 1
  • Naohiko Takahashi
    • 1
  1. 1.Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufu CityJapan

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