{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:45:05Z","timestamp":1762004705193},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>We aimed to determine the impact of renal function on long-term outcomes with cardiac resynchronization therapy with defibrillator among patients with mild heart failure (HF).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We stratified 1820 Multicenter Automatic Defibrillator Implantation Trial\u2013Cardiac Resynchronization Therapy patients by QRS morphology into those with and without left bundle-branch block. Subgroups within each QRS morphology category were created based on glomerular filtration rate (GFR): GFR &lt;60 and \u226560 mL\/min per 1.73 m\n              <jats:sup>2<\/jats:sup>\n              . Primary end point was death; secondary end points were HF\/death and HF events alone during long-term follow-up. Among 1274 left bundle-branch block patients, 413 (32%) presented with GFR &lt;60 (mean, 48.1\u00b18.3) mL\/min per 1.73 m\n              <jats:sup>2<\/jats:sup>\n              . Relative to the 861 (68%) patients with GFR \u226560 (mean, 79.6\u00b116.0) mL\/min per 1.73 m\n              <jats:sup>2<\/jats:sup>\n              , low-GFR patients experienced higher risk of death (hazard ratio [HR], 2.09; 95% confidence interval [CI], 1.53\u20132.86;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01) and HF\/death (HR, 1.46; 95% CI, 1.17\u20131.82;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). In both GFR groups, cardiac resynchronization therapy with defibrillator was associated with reduction in death (GFR &lt;60: HR, 0.66; 95% CI, 0.44\u20131.00;\n              <jats:italic>P<\/jats:italic>\n              =0.05 and GFR \u226560: HR, 0.68; 95% CI, 0.44\u20131.05;\n              <jats:italic>P<\/jats:italic>\n              =0.08) and HF\/death (GFR &lt;60: HR, 0.49; 95% CI, 0.36\u20130.67;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 and GFR \u226560: HR, 0.50; 95% CI, 0.38\u20130.66;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). In the low-GFR group, there was greater absolute reduction in risk of death (GFR &lt;60: 14% and GFR \u226560: 6%) and HF\/death (GFR &lt;60: 25 and GFR \u226560: 15%). Among non\u2013left bundle-branch block patients, low GFR predicted outcomes; however, no benefit from cardiac resynchronization therapy with defibrillator was observed.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In patients with mild HF, moderate renal dysfunction is associated with higher risk of death and HF during long-term follow-up. Patients with left bundle-branch block, regardless of baseline renal function, derive long-term benefit from cardiac resynchronization therapy with defibrillator, with greater absolute risk reduction in death and HF among those with moderate renal dysfunction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifiers: NCT00180271, NCT01294449, and NCT02060110.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.115.002082","type":"journal-article","created":{"date-parts":[[2015,6,3]],"date-time":"2015-06-03T15:28:05Z","timestamp":1433345285000},"page":"725-732","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Long-Term Outcomes With Cardiac Resynchronization Therapy in Patients With Mild Heart Failure With Moderate Renal Dysfunction"],"prefix":"10.1161","volume":"8","author":[{"given":"Usama A.","family":"Daimee","sequence":"first","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur J.","family":"Moss","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yitschak","family":"Biton","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helmut U.","family":"Klein","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronislava","family":"Polonsky","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Zareba","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilan","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Kutyifa","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, Division of Cardiology, University of Rochester Medical Center, NY (U.A.D., A.J.M., Y.B., H.U.K., S.M., B.P., W.Z., I.G., V.K.); and Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000116764.53225.A9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.2.203"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.580506"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00608-7"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1054\/jcaf.2003.3"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1054\/jcaf.2002.125289"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2003.08.012"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.03.011"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.031"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000018409.45834.FA"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl099"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.027"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2005.00073.x"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401426"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.06.060"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02705.x"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs135"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.09.005"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12502"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2006.11.015"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2008.03.009"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.960898"},{"key":"e_1_3_4_28_2","first-page":"1","article-title":"KDIGO clinical practice guideline for the evaluation and management of chronic kidney disease.","volume":"3","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2013","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. 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