PhD Scientific Days 2024

Poster Session T - Cardiovascular Medicine and Research 3.

Upgrading right ventricular pacing to cardiac resynchronization in HFrEF patients improves symptoms and functional outcomes. Results from the BUDAPEST-CRT Upgrade trial

Előadó neve

Dr. Merkel, Eperke

Neptun code

E85DK3

Előadó munkahelye

Semmelweis University Heart and Vascular Center

Előadó telefonszáma

06206701214

Előadó e-mail címe

merkel.eperke@gmail.com

Az előadás címe

Upgrading right ventricular pacing to cardiac resynchronization in HFrEF patients improves symptoms and functional outcomes. Results from the BUDAPEST-CRT Upgrade trial

Szerző(k) neve és munkahelye

Eperke Merkel-Pólos¹, Robert Hatala², Matyas Szigeti¹, Walter Schwertner¹, Balint Lakatos¹, Anett Behon¹, Kinga Goscinska-Bis³, Goran Milasinovic⁴, Roland Papp¹, Mihaly Ruppert¹, Laszlo Saghy⁵, Marcell Clemens⁶, Scott D. Solomon⁷, Valentina Kutyifa⁸, Attila Kovacs¹, Annamaria Kosztin¹, Bela Merkely¹

1: Semmelweis University, Heart and Vascular Center
2: National Institute of Cardiovascular Diseases and Slovak Medical University, Department of Cardiology and Angiology, Bratislava, Slovakia
3: Medical University of Silesia
4: Referral Pacemaker Center, Clinical Centre of Serbia, Belgrade, Serbia
5: Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged
6: Department of Cardiology, University of Debrecen
7: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School
8: Clinical Cardiovascular Research Center, University of Rochester

Bemutatás módja

Poszter

Szekció

Poster Session T - Cardiovascular Medicine and Research 3.

Language of the presentation

English

Preferred session

Cardiovascular Medicine and Research

Összefoglaló szövege

Introduction: In BUDAPEST-CRT Upgrade randomized trial we have demonstrated improved mortality and morbidity after CRT upgrade in patients with HFrEF with high RV pacing burden.
Aims: This substudy sought to examine the impact of CRT upgrade on symptoms, functional outcome, and exercise capacity.
Methods: In the BUDAPEST-CRT Upgrade trial 360 HFrEF patients with a pacemaker or implantable cardioverter defibrillator (ICD) and ≥20% RV pacing burden were randomly assigned (3:2) to CRT-D upgrade (n=215) or ICD (n=145). The prespecified tertiary endpoints were changes in quality of life (QoL; EQ-5D-3L), New York Heart Association (NYHA) functional class, 6-minute walk test (6-MWT), and NT-proBNP levels.
Results: Up to 12 months, NYHA improved in the CRT-D upgrade arm compared with ICD only [adjusted odds ratio 0.50; 95% CI 0.32-0.80; P=0.003]. A remarkable decrease was observed in NT-proBNP levels in the CRT-D arm [adjusted difference -1257 pg/mL; 95% CI -2287 – (-228); P=0.017]. The progression of age-related worsening of QoL was moderated by CRT-D upgrade (EQ-5D-3L difference by each year: 0.015; 95% CI 0.005 - 0.025; interaction P=0.003). However, exercise tolerance (6-MWT) remained unchanged in both groups.
Conclusions: HFrEF patients with PM/ICD and ≥20% RV pacing burden receiving CRT upgrade showed a substantial improvement in NYHA class and decrease in natriuretic peptide levels, as compared to ICD alone. Moreover, CRT-D upgrade could moderate the progression of worsening of QoL attributed to ageing in this vulnerable, elderly patient population.

Funding: The BUDAPEST CRT Upgrade study was an investigator-initiated research trial, sponsored by Semmelweis University, receiving an unrestricted grant from Boston Scientific to conduct the study. The trial was supported by the ‘National Heart Program’ (Project no. NVKP_16-1–2016-0017) with support provided by the National Research Development and Innovation Fund of Hungary. Project no. RRF-2.3.1-21-2022-00003 has been implemented with the support provided by the European Union. These sources played no role in the design, execution, or analysis of the trial results. An.K. and At.K. were supported by the Bolyai Janos Research Scholarship by the Hungarian Academy of Sciences. E.M. was also supported by the Semmelweis 250+ Excellence Ph.D. Scholarship (EFOP-3.6.3-VEKOP-16-2017-00009).

University

Semmelweis University

Supervisor

Annamaria Kosztin

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4650

Start

16:40

End

16:43