The relationship between LV-RR, defined as a 10 % reduction in LV end-systolic volume, and renal function was examined in 85 consecutive patients receiving CRT. Echocardiographic assessment and renal function tests were performed before and 3 months after CRT. All-cause mortality and the composite of mortality or heart failure hospitalization between those with preserved or deteriorated renal function at 3 months were assessed by Kaplan Meier analysis.
There was a slight improvement in glomerular filtration rate (GFR) in those with LV-RR (n = 44; 51.7 ± 20.4 vs. 54.2 ± 19.1 ml/min/1.73m2; p = 0.024) while a significant deterioration (n = 41; 61.9 ± 17 vs. 48.8 ± 13.0 ml/min/1.73m2; p < 0.001) was observed in those without LV-RR. The change (Δ) in GFR was significantly correlated with ΔLV end-systolic/diastolic volumes and ΔLV ejection fraction. After follow up of 856.4 ± 576.8 days, patients with preserved renal function had significant lower all-cause mortality (log rank χ2 = 4.82, p = 0.029) and the composite endpoints (log rank χ2 = 5.04, p = 0.025).
Preservation of renal function was observed in patients with systolic heart failure and renal insufficiency responding to CRT and provided prognostic information. A rapid decline in renal function after CRT was associated with worse clinical outcomes.