Key result
CRT upgrading in PICM is linked to improved functional MR grading.
Why the study?
Data on the effects of conventional CRT upgrading on functional mitral regurgitation in patients with pacing-induced cardiomyopathy are scarce.
Does conventional cardiac resynchronization therapy upgrading improve functional mitral regurgitation in patients with pacing-induced cardiomyopathy?
Observational (n=54)
Does conventional cardiac resynchronization therapy upgrading improve functional mitral regurgitation in patients with pacing-induced cardiomyopathy?
Conventional CRT upgrading in pacing-induced cardiomyopathy significantly improves functional mitral regurgitation, though baseline moderate-to-severe MR remains a strong predictor of long-term mortality.
Answers are grounded in this paper and cite their sources.
CRT upgrade was associated with MR improvement in pacing-induced cardiomyopathy; leaves open need for dedicated prospective trials before practice change.
Background Data on the effects of conventional cardiac resynchronization therapy (CRT) upgrading by implantation of a left ventricular lead via the coronary sinus on functional mitral regurgitation (MR) in patients with pacing-induced cardiomyopathy are scarce. Methods This analysis of the UPGRADE study, an investigator-initiated randomized controlled trial to evaluate the effect of conventional CRT on central sleep apnea, evaluated the significance of CRT on MR in all included patients. Differences in all-cause mortality were assessed in patients with significant MR during long-term follow-up. Results Overall, 54 patients were included in the trial. MR was found in the majority of patients [mild: n = 30 (55.6%), moderate: n = 15 (27.8%), severe: n = 6 (11.1%)], while “none/trace” MR was observed in only three (5.6%) patients. CRT was associated with a significant reduction in MR [“none/trace”: n = 5 (9.6%), mild: n = 37 (71.2%), moderate: n = 6 (11.5%), severe: n = 4 (7.7%); p = 0.035)] after 3–5 months, with all patients either having an improvement in MR grading or it remaining unchanged. Notably, only two patients with severe MR improved to either a mild or moderate level. CRT upgrading was linked to a significant amelioration of vena contracta width [2 mm (1.0–4.3) at baseline versus 2 mm (1.0–3.0) post-CRT; r = 0.73, 95% CI 0.53–0.85, p < 0.001]. The presence of significant MR at baseline was associated with impaired survival during long-term follow-up [MR < 2: n = 14 (42.4%), MR ≥ 2: n = 19 (90.5%); hazard ratio 0.25 (95% CI 0.12–0.54); log rank p < 0.001]. Conclusion Conventional CRT upgrading in patients with pacing-induced cardiomyopathy was associated with significant improvement in MR grading. The presence of moderate or severe MR at baseline was associated with impaired outcomes during long-term follow-up, suggesting that these patients represent a high-risk cohort.
No takes yet. Share an insight, caveat, or question.
Adukauskaitė et al. (2026) conducted an observational in Pacing-induced cardiomyopathy with functional mitral regurgitation (n=54). Conventional cardiac resynchronization therapy (CRT) upgrading vs. Baseline (pre-CRT activation) was evaluated on Improvement and change in functional mitral regurgitation (MR) grading 3-5 months post-CRT activation (p=0.035). Conventional cardiac resynchronization therapy upgrading in patients with pacing-induced cardiomyopathy was associated with a significant improvement in functional mitral regurgitation grading.
Synapse has enriched 10 related papers. Consider them for comparative context: