(NVKP-16-1-2016-0017 National Heart Program) Támogató: NKFIH
(2020-4.1.1.-TKP2020)
János Bolyai Research Scholarship of the Hungarian Academy of Sciences
Szakterületek:
Orvos- és egészségtudomány
Szív és keringési rendszer
The BUDAPEST-CRT Upgrade study is the first prospective, randomized, multicentre clinical
trial investigating the outcomes after cardiac resynchronization therapy (CRT) upgrade
in heart failure (HF) patients with intermittent or permanent right ventricular pacing
(RVP) with wide paced QRS. This report describes the baseline clinical characteristics
of the enrolled patients and compares them to cohorts from previous milestone CRT
studies.This international multicentre randomized controlled trial investigates 360
patients having a pacemaker (PM) or implantable cardioverter defibrillator (ICD) device
for at least six months prior to enrollment, reduced left ventricular ejection fraction
(LVEF≤35%), HF symptoms (New York Heart Association functional class II-IVa), wide
paced QRS (>150 ms), and ≥20% of RVP burden without having a native left bundle branch
block. At enrollment, the mean age of the patients was 73±8 years; 89% were male,
97% of the patients were in NYHA II/III functional class, and 56% had atrial fibrillation.
Enrolled patients predominantly had conventional PM devices, with a mean RVP burden
of 86%. Thus, this is a patient cohort with advanced HF, low baseline LVEF (25%±7%),
high N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels [2231 pg/mL (25th
- 75th percentile 1254/4309 pg/mL)], and frequent HF hospitalizations during the preceding
12 months (50%).When compared with prior CRT trial cohorts, the BUDAPEST-CRT Upgrade
study includes older patients with a strong male predominance and a high burden of
atrial fibrillation and other comorbidities. Moreover, this cohort represents an advanced
HF population with low LVEFs, high NT-proBNPs, and frequent previous HF events.