Outcomes of Cardiac ResynchronizationTherapy in Heart Failure Patientsand Effect of MAGGIC-HF Score onPrognosis

Abstract

Objectives: Cardiac resynchronization therapy (CRT) has recently become a significant treatment option in patients with heart failure (HF), who do not respond to optimal medical treatment. In this study, we aimed to evaluate the long-term prognosis of CRT and to determine the relationship between the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC-HF) risk score and CRT.Materials and Methods: One hundred and ten consecutive patients who underwent CRT between 2015 and 2019 were analyzed retrospectively. Baseline characteristics of the patients were recorded and clinical parameters including laboratory, electrocardiographic and echocardiographic were compared before CRT implantation and during patient follow-up. The patients were classified as surviving patients and patients without survival according to the 2-year clinical outcome. The improvement in echocardiographic parameters observed at the 6th month after CRT in surviving patients was defined as a positive response to CRT.Results: The patients with survival had lower pulmonary artery systolic pressure (PASP) (34.66±18.31 vs 46.50±15.86 p=0.01) and higher left ventricular ejection fraction (LVEF) than patients without survival (27.00±5.86 vs 23.89±5.32 p=0.04). After 6 months from CRT implantation, the improvement of LVEF and PASP and decrease in left ventricular diameters were found in patients with survival (p=0.015). In addition, there was a weak correlation between MAGGIC risk score levels and hospitalizations in this study population (p=0.031, r=208)Conclusion: Predictors of long-term survival in CRT treatment are basal LVEF and PASP levels. Basal LVEF is important in the positive response to CRT