Abstract 3072: Beneficial Effects of Cardiac Resynchronization Therapy in Patients with Class Two Heart Failure

Abstract

Cardiac resynchronization therapy (CRT) improves heart failure (HF) symptoms in patients (pts) with EF <35%, QRS >120ms, and NYHA class 3 and 4 HF. The aim of this study was to compare the effects of CRT in pts with EF <35%, QRS >130, and class 2 vs 3/4 HF. We enrolled 25 patients. All received ECGs, transthoracic echocardiograms, 6 minute walk tests, and Minnesota quality of life questionnaires pre-op and three months post-op. Fourteen pts were class 2, 10 patients were class 3, and 1 class 4. Ischemic cardiomyopathy accounted for 7 out of the 14 class 2 pts and 5 out of the 11 class 3/4 pts. As a group, all patients had a significant increase in 6 minute walk (1150 vs 1249, p=0.02), increase in EF (30% vs 39%, p<0.01), decreased QRS duration (162 vs 143, p=0.001), and improved quality of life scores (31.1 vs 21.7, p=0.03), comparing pre and post-op measurements. There was no significant difference in response of class 2 versus class 3/4 pts (see table ). Nonischemic pts had greater response than ischemic pts. Class 2 HF pts reported greater improvement in mental health than class 3 and 4. Younger patients reported greater functional improvement, while pts with higher BMI reported less physical benefit. Summary: Pts with NYHA class 2 symptoms derive similar hemodynamic benefit from CRT as pts with class 3/4 symptoms and may derive greater mental health benefits than class 3/4 pts. Comparison of Pre and Post-Implant Parameters Between Class 2 and 3/4 Patients