Cardiorenal Resynchronization Therapy

Obeng-Gyimah, Edmond; Deo, Rajat

doi:10.2215/cjn.09120815

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…CRT improves LV function and reduces both hospitalisation and mortality in patients with symptomatic HFrEF and ventricular desynchrony (LBBB or QRS duration >120 ms) 10. Increasing LV function improves organ perfusion, reducing sympathetic and renin–angiotensin–aldosterone system activity 10. This may improve cardiorenal syndrome and reduce renal events 10…”

Section: Discussionmentioning

confidence: 99%

“…Increasing LV function improves organ perfusion, reducing sympathetic and renin–angiotensin–aldosterone system activity 10. This may improve cardiorenal syndrome and reduce renal events 10…”

Section: Discussionmentioning

confidence: 99%

“…‘Cardiorenal resynchronization therapy’ has been explored 10 11. However, advanced CKD and hypernatraemia have been associated with increased mortality post CRT 11.…”

Section: Discussionmentioning

confidence: 99%

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Benefit of natriuresis and cardiac resynchronisation therapy in acute decompensated heart failure with cardiorenal syndrome and hypernatraemia

et al. 2022

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A man in his eighties with acute heart failure and cardiorenal syndrome developed severe hypernatraemia with diuresis. In this situation, palliation is often considered when renal replacement therapy is inappropriate. The literature to guide treatment of dysnatraemia in this setting is limited. Diuretics often worsen hypernatraemia and fluid replacement exacerbates heart failure. We describe a successful approach to this clinical Catch-22: sequential nephron blockade with intravenous 5% dextrose. Seemingly counterintuitive, the natriuretic effect of this combination had not previously been compared with diuretic monotherapy for heart failure. Yet this immediately effective strategy generated a high natriuresis-to-diuresis ratio and functioned as a bridge to cardiac resynchronisation therapy (CRT). In conjunction with a low salt diet, CRT facilitated the maintenance of sodium homeostasis and fluid balance. Thus, by improving the underlying pathophysiology (ie, inadequate cardiac output), CRT may enhance the outcomes of patients with cardiorenal syndrome and hypernatraemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Benefit of natriuresis and cardiac resynchronisation therapy in acute decompensated heart failure with cardiorenal syndrome and hypernatraemia

et al. 2022

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“…This intervention should improve myocardial function and may be particularly attractive in selected individuals with CKD [25]. It is known, however, that patients who do not respond to such CRT treatment (non -responders) have a much higher risk of re-hospitalization and mortality [26]. Therefore, it is important to identify patients who do not respond to CRT therapy.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers to Predict the Renal Response to Cardiac Resynchronization Therapy During a Three-Month Follow-Up: Prospective Clinical Trial

Gala-Błądzińska¹,

Kubrak²,

Czech³

et al. 2020

Preprint

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BackgroundChronic cardiorenal syndrome type 2 (CRS-T2) has a complex pathophysiology. The objective of this study was to assess renal function using biomarkers associated with nephron injury sites in patients with CRS-T2 following cardiac resynchronization therapy (CRT). MethodsThe research included patients with heart failure in NYHA classes II-IV, in whom CRT devices had been implanted. After 3 months of follow-up, the research group was divided into CRT responders and CRT non-responders. Prior to CRT and after 3 months, renal function was assessed using biomarkers measured in urine and blood samples.ResultsCRT was implanted in 56 patients (aged 66 ± 10 years) with CRS-T2 in the course of coronary artery disease (n = 38; 67.9%) or dilated cardiomyopathy (n = 18). Estimated glomerular filtration rate (eGFRCKD-EPI) was 68.55 ± 20.34 mL/min/1.73m2. After three months follow-up CRT responder group were assessed showing a significant decrease in serum prostaglandin D2 synthase (sPGD2S) and albuminuria (uACR) concentrations. Urine samples of the CRT non-responder group showed significant (p <0.05) increases in lipocalin associated with neutrophil gelatinase (uNGAL) concentrations, and a decrease in cystatin C (uCysC) concentration. There were no significant changes in the concentration of serum creatinine (sCr), CysC and eGFRCKD-EPI between the CRT responders and CRT non - responders groups.ConclusionsThe sCr and eGFRCKD-EPI assessment are useless in evaluation of renal function three months after CRT implantation. Biomarkers that account for the pathophysiology of nephron injury in CRS-T2 and change significantly after CRT are: sPGD2S, uACR, uCysC, and uNGAL. Trial registrationThis study is registered with ClinicalTrials.gov, Identifier: NCT04516525. Registered 15 August 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04516525.

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Type 2 Cardiorenal Syndrome

Rocha¹,

McCullough

2020

Textbook of Cardiorenal Medicine

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Cardiorenal Resynchronization Therapy

Cited by 4 publications

References 18 publications

Benefit of natriuresis and cardiac resynchronisation therapy in acute decompensated heart failure with cardiorenal syndrome and hypernatraemia

Benefit of natriuresis and cardiac resynchronisation therapy in acute decompensated heart failure with cardiorenal syndrome and hypernatraemia

Biomarkers to Predict the Renal Response to Cardiac Resynchronization Therapy During a Three-Month Follow-Up: Prospective Clinical Trial

Type 2 Cardiorenal Syndrome

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