Abstract
Background: Liver function may be a useful indicator of response to cardiac resynchronization therapy (CRT). We aimed to investigate the clinical significance of albumin-bilirubin (ALBI) score, an assessment tool of liver function, on outcomes in heart failure (HF) patients treated with CRT. Methods: We studied 180 patients undergoing CRT. The ALBI score, derived from albumin and total bilirubin, and left ventricular ejection fraction (LVEF) were assessed before and 6 months after CRT. The patients were classified according to the ALBI score before CRT; High (>−2.60) or Low (≤−2.60) ALBI groups. The patients were then reclassified based on the ALBI score before and 6 months after CRT; High/High, High/Low, Low/High, and Low/Low ALBI groups. We evaluated the prognostic value of the ALBI score for HF deaths after CRT. Results: During a median follow-up period of 50 months, there were 41 (22.7%) HF deaths. A Cox proportional hazard analysis revealed that high ALBI scores at baseline were not related to HF deaths (hazard ratio, 1.907, p = 0.068). However, High/High ALBI scores, but not High/Low or Low/High ALBI scores, were an independent predictor of HF deaths compared with Low/Low ALBI scores (hazard ratio, 3.449, p = 0.008), implying that consistently high ALBI scores were associated with poor prognosis. The percentage change in LVEF from baseline to 6 months after CRT did not differ among the four groups, suggesting that left ventricular systolic function was not linked with the ALBI score. Conclusions: ALBI scores before and after CRT are a new indicator of CRT response, and have a predictive value for HF deaths in HF patients.
Highlights
Cardiac resynchronization therapy (CRT) is regarded as a well-established therapy for patients with advanced heart failure (HF) [1]
There is a wide variability in the extent of ventricular remodeling and improvement in clinical conditions in patients treated with cardiac resynchronization therapy (CRT), response to CRT is often determined based on the assessment of left ventricular (LV) systolic function after CRT [2,3]
We aimed to investigate the clinical significance of ALBI scores before and after CRT in the prognosis of HF patients
Summary
Cardiac resynchronization therapy (CRT) is regarded as a well-established therapy for patients with advanced heart failure (HF) [1]. Elevated bilirubin, a serum cholestasis marker, is related to acute liver congestion, and decreased albumin is associated with chronic congestive hepatopathy and poor prognosis in HF patients [7]. Liver function may be a useful indicator of response to cardiac resynchronization therapy (CRT). Score, an assessment tool of liver function, on outcomes in heart failure (HF) patients treated with. The ALBI score, derived from albumin and total bilirubin, and left ventricular ejection fraction (LVEF) were assessed before and 6 months after CRT. The percentage change in LVEF from baseline to 6 months after CRT did not differ among the four groups, suggesting that left ventricular systolic function was not linked with the ALBI score. Conclusions: ALBI scores before and after CRT are a new indicator of CRT response, and have a predictive value for HF deaths in HF patients
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