Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders
Abstract Aims Data regarding contrast‐induced nephropathy (CIN) after cardiac resynchronization therapy (CRT) implant are limited. We aimed to investigate the incidence and determinants of CIN and its impact on CRT response and outcomes. Methods and results Patients who underwent CRT implant were re...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12523 |
| _version_ | 1818312154344849408 |
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| author | Teresa Strisciuglio Giuseppe Ammirati Valerio Pergola Livio Imparato Cristina Carella Elisabeta Koci Rosaria Chiappetti Fabio Giovanni Abbate Vincenzo Mirco La Fazia Aniello Viggiano Bruno Trimarco Antonio Rapacciuolo |
| author_facet | Teresa Strisciuglio Giuseppe Ammirati Valerio Pergola Livio Imparato Cristina Carella Elisabeta Koci Rosaria Chiappetti Fabio Giovanni Abbate Vincenzo Mirco La Fazia Aniello Viggiano Bruno Trimarco Antonio Rapacciuolo |
| author_sort | Teresa Strisciuglio |
| collection | DOAJ |
| description | Abstract Aims Data regarding contrast‐induced nephropathy (CIN) after cardiac resynchronization therapy (CRT) implant are limited. We aimed to investigate the incidence and determinants of CIN and its impact on CRT response and outcomes. Methods and results Patients who underwent CRT implant were retrospectively analysed, and CIN was defined as an increase of serum creatinine ≥0.3 mg/dL or ≥1.5 times the baseline value. Response to CRT was defined as a reduction of left ventricle end‐systolic volume (LVESV) of 15% or the increase of five percentage points in ejection fraction (EF) as assessed by echocardiography at 6 months. Follow‐up visits were scheduled at 3, 6, and 12 months. Contrast‐induced nephropathy occurred in 13/107 patients (12%). Among baseline clinical, echocardiographic, and laboratory characteristics, only a high baseline serum creatinine was associated with the occurrence of CIN. Symptoms, EF, and LVESV at 6 months improved in both CIN and non‐CIN patients, and the rate of responders to CRT was similar. Among responders, at 6 months, those with CIN had significantly lower EF (28.5% vs. 35.7% P = 0.003). At a median follow‐up of 112 weeks, 43% of patients experienced a clinical event with similar incidence in CIN and non‐CIN patients, and likewise survival was similar. Non‐responders to CRT had worse survival while among responders those with CIN had worse survival than non‐CIN patients (71% vs. 90%, P = 0.0035). Conclusions The incidence of CIN is rather high. Although CIN does not influence response to CRT overall, however among responders impairs the recovery of EF and survival. |
| first_indexed | 2024-12-13T08:13:20Z |
| format | Article |
| id | doaj.art-29f6e8c2a9714d2ebfec5355db1b2a5c |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-13T08:13:20Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-29f6e8c2a9714d2ebfec5355db1b2a5c2022-12-21T23:54:09ZengWileyESC Heart Failure2055-58222019-12-01661266127310.1002/ehf2.12523Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in respondersTeresa Strisciuglio0Giuseppe Ammirati1Valerio Pergola2Livio Imparato3Cristina Carella4Elisabeta Koci5Rosaria Chiappetti6Fabio Giovanni Abbate7Vincenzo Mirco La Fazia8Aniello Viggiano9Bruno Trimarco10Antonio Rapacciuolo11Department of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyDepartment of Advanced Biomedical Sciences University of Naples Federico II Naples ItalyAbstract Aims Data regarding contrast‐induced nephropathy (CIN) after cardiac resynchronization therapy (CRT) implant are limited. We aimed to investigate the incidence and determinants of CIN and its impact on CRT response and outcomes. Methods and results Patients who underwent CRT implant were retrospectively analysed, and CIN was defined as an increase of serum creatinine ≥0.3 mg/dL or ≥1.5 times the baseline value. Response to CRT was defined as a reduction of left ventricle end‐systolic volume (LVESV) of 15% or the increase of five percentage points in ejection fraction (EF) as assessed by echocardiography at 6 months. Follow‐up visits were scheduled at 3, 6, and 12 months. Contrast‐induced nephropathy occurred in 13/107 patients (12%). Among baseline clinical, echocardiographic, and laboratory characteristics, only a high baseline serum creatinine was associated with the occurrence of CIN. Symptoms, EF, and LVESV at 6 months improved in both CIN and non‐CIN patients, and the rate of responders to CRT was similar. Among responders, at 6 months, those with CIN had significantly lower EF (28.5% vs. 35.7% P = 0.003). At a median follow‐up of 112 weeks, 43% of patients experienced a clinical event with similar incidence in CIN and non‐CIN patients, and likewise survival was similar. Non‐responders to CRT had worse survival while among responders those with CIN had worse survival than non‐CIN patients (71% vs. 90%, P = 0.0035). Conclusions The incidence of CIN is rather high. Although CIN does not influence response to CRT overall, however among responders impairs the recovery of EF and survival.https://doi.org/10.1002/ehf2.12523Contrast‐induced nephropathyHeart failureCardiac resynchronization therapy |
| spellingShingle | Teresa Strisciuglio Giuseppe Ammirati Valerio Pergola Livio Imparato Cristina Carella Elisabeta Koci Rosaria Chiappetti Fabio Giovanni Abbate Vincenzo Mirco La Fazia Aniello Viggiano Bruno Trimarco Antonio Rapacciuolo Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders ESC Heart Failure Contrast‐induced nephropathy Heart failure Cardiac resynchronization therapy |
| title | Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders |
| title_full | Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders |
| title_fullStr | Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders |
| title_full_unstemmed | Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders |
| title_short | Contrast‐induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders |
| title_sort | contrast induced nephropathy after cardiac resynchronization therapy implant impairs the recovery of ejection fraction in responders |
| topic | Contrast‐induced nephropathy Heart failure Cardiac resynchronization therapy |
| url | https://doi.org/10.1002/ehf2.12523 |
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