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Ten-year follow-up of cardiac resynchronization therapy patients with non-ischemic dilated cardiomyopathy assessed by radionuclide angiography: a single-center cohort study

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Relatively few data are available on long-term survival and incidence of ventricular arrhythmias in cardiac resynchronization therapy (CRT) patients. We investigated long-term outcomes of CRT patients with non-ischemic dilated cardiomyopathy stratified as responders or non-responders according to radionuclide angiography.

Methods

Fifty patients with non-ischemic dilated cardiomyopathy undergoing CRT were assessed by equilibrium Tc99 radionuclide angiography with bicycle exercise at baseline and after 3 months. Intra- and interventricular dyssynchrony were derived by Fourier phase analysis. Patient clinical outcome was assessed after 10 years.

Results

At 3 months, 50% of patients were identified as CRT responders according to an increase in LV ejection fraction ≥ 5%. During a follow-up of 109 ± 48 months, 30% of patients died and 6% underwent heart transplantation. Age and history of paroxysmal atrial fibrillation were found to be predictors of all-cause mortality. CRT responders showed lower risk of death from cardiac causes than non-responders. At follow-up, 38% of patients presented at least one episode of sustained ventricular tachycardia, with a similar percentage between responders and non-responders.

Conclusion

At long-term follow-up, non-ischemic CRT recipients identified as responders by radionuclide angiography were found to be at lower risk of worsening heart failure death than non-responders. Long-term risk for sustained ventricular arrhythmia was similar between CRT responders and non-responders.

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Abbreviations

AF:

Atrial fibrillation

CRT:

Cardiac resynchronization therapy

CRT-D:

Cardiac resynchronization therapy device with defibrillator capabilities

ICD:

Implantable cardioverter defibrillator

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

PER:

Peak ejection rate

PFR:

Peak filling rate

RV:

Right ventricular

RVEF:

Right ventricular ejection fraction

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Authors and Affiliations

  1. Department of Cardiology, IRCCS, Azienda Ospedaliero Universitaria Di Bologna, Policlinico Di S.Orsola, Via Massarenti 9, 40138, Bologna, Italy

    Cinzia Valzania, Giulia Massaro, Alberto Spadotto, Jessica Frisoni, Cristian Martignani, Matteo Ziacchi, Igor Diemberger, Mauro Biffi & Nazzareno Galié

  2. Department of Nuclear Medicine, IRCCS, Azienda Ospedaliero Universitaria Di Bologna, Policlinico Di S.Orsola, Bologna, Italy

    Lorenzo Muraglia & Stefano Fanti

  3. Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy

    Igor Diemberger, Stefano Fanti & Nazzareno Galié

  4. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Polyclinic of Modena, Modena, Italy

    Giuseppe Boriani

Authors
  1. Cinzia Valzania
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  2. Giulia Massaro
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  3. Alberto Spadotto
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Correspondence to Cinzia Valzania.

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Valzania, C., Massaro, G., Spadotto, A. et al. Ten-year follow-up of cardiac resynchronization therapy patients with non-ischemic dilated cardiomyopathy assessed by radionuclide angiography: a single-center cohort study. J Interv Card Electrophysiol 64, 723–731 (2022). https://doi.org/10.1007/s10840-022-01117-z

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