Patients
We retrospectively reviewed the data bases of the CRT upgrade cases with
NICM at Kobe University Graduate School of Medicine between 2006 and
2019 and Hyogo Brain and Heart Center between 2010 and 2019.
The upgrade to CRT from a
pacemaker or ICD was performed in patients with an LV ejection fraction
(LVEF) of ≤ 35% and New York Heart Association (NYHA) class of Ⅱ-Ⅳ. The
selection of CRT with or without a defibrillator was determined by the
attending physicians. The CRT procedure upgrade was carried out with the
use of standard transvenous techniques.
CS was diagnosed according to the current
guidelines.11Seven patients with CS had a
histological diagnosis. The other
patients with CS were diagnosed based on the clinical and imaging
findings, including echocardiography, 67Ga
scintigraphy, myocardial perfusion scintigraphy
(99mTc-tetrofosmin), positron emission
tomography/computed tomography (PET/CT), and cardiac magnetic resonance.
The enrolled patients who underwent a CRT upgrade were divided into 3
groups: group 1 was comprised of patients with CS who had taken
corticosteroids before the CRT upgrade; group 2 was comprised of
patients with CS who had not taken corticosteroids before the CRT
upgrade; and group 3 was comprised of patients with other NICMs. We
compared the following outcomes among the three groups: 1)
echocardiographic response to CRT (before and 6 months after the CRT
upgrade), 2) sustained ventricular tachyarrhythmia events, 3) composite
outcomes of cardiovascular death and hospitalizations for worsening
heart failure.
This retrospective study complied with the principles of the Declaration
of Helsinki. The study was approved by the ethics committee of Kobe
University Hospital (No. B200243).