Functional and clinical implications of cardiac resynchronization therapy on outcomes of diabetic patients with heart failure

AIMS: To compare functional and structural changes of the left ventricle and long-term clinical outcomes in diabetic and nondiabetic patients with heart failure undergoing cardiac resynchronization therapy (CRT). METHODS: Sixty-eight patients with heart failure undergoing CRT were included: 18 were diabetic patients and 50 nondiabetic patients. The CRT eligibility was established by echocardiographic assessments. RESULTS: CRT improved ventricular geometry and dyssynchrony in both diabetic and nondiabetic patients, with no significant difference in the magnitude of the effects on the left ventricular function. Over a median follow-up of 30.6 ± 6.2 months, there were no significant differences in the rates of any cause death (16.7 vs. 14.0%, P = 0.72), cardiac death (11.1 vs. 8.0%, P = 0.65) and heart rehospitalization (5.6 vs. 6.0%, P = 1.0), between diabetic and nondiabetic patients, respectively. Diabetes was not found to be an independent factor associated with worse clinical outcome. CONCLUSION: Resynchronization therapy provided significant functional and hemodynamic improvements in both diabetic and nondiabetic patients. Long-term prognosis in heart failure patients with diabetes was comparable with that in those without diabetes.