The Impact Of Renal Insufifciency On The Clinical Outcome Of Heart Failure Patients Treated With Cardiac Resynchronize Therapy

Objective：To study the impact of renal function on the clinical outcome of heartfailure patients treated with cardiac resynchronize therapy.Method: We evaluated51consecutive patients who underwent CRT at our hospitalbetween2007and2012. The patients were divided into two groups according to aglomerular filtration rate (GFR) cut-off value of60ml/min. GFR were calculated byMDRD method. Then we compared clinical outcomes between the two groups.Results: after a mean follow-up period of31.4months, patients with advanced renalinsufficiency (GFR <60ml/min) had significant higher all-cause mortality (log-rankP=0.02) and higher all-cause mortality combined with HF hospitalization (log-rank P=0.001) than patients with GFR≥60ml/min. Multivariate analysis revealed that GFRwas an independent predictor of mortality combined with HF hospitalization (oddsratio=0.947, P=0.024). LVESd and ACEI/ARB therapy were independent predictorof cardiac mortality combined with HF hospitalization as well.Conclusion: Advanced renal insufficiency is predetective of worsening clinicaloutcomes in HF patients treated with CRT. GFR, LVESd and ACEI/ARB therapywere independent predictor of cardiac mortality combined with HF hospitalization.Preservation of renal function after CRT brings about better survival throughprevention of adverse cardiac events, even in HF patients with advanced renalinsufficiency.