Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title Stratification of Destination Therapy Candidates by J-HeartMate Risk Score Among Elderly Non-Responders to Cardiac Resynchronization Therapy.
Journal Formal name:Circulation reports
Abbreviation:Circ Rep
ISSN code:24340790/24340790
Domestic / ForeginForegin
Volume, Issue, Page 4(9),pp.405-411
Author and coauthor Yoshimura Asami†, Kikuchi Noriko, Saito Satoshi, Suzuki Atsushi, Hattori Hidetoshi, Shoda Morio, Ichihara Yuki, Niinami Hiroshi, Hagiwara Nobuhisa, Yamaguchi Junichi, Nunoda Shinichi
Publication date 2022/08/26
Summary Background: For elderly patients with refractory heart failure (HF), destination therapy (DT) with a continuous-flow left ventricular assist device (LVAD) is a possible treatment. The aim of DT is for long-term, satisfying quality of life on LVAD support. Previously, elderly non-responders to cardiac resynchronization therapy (CRT) were primarily destined for palliative care, but DT has been available in Japan since April 30, 2021. This study investigated the prognosis of elderly CRT non-responders and assessed the feasibility of DT in these patients based on the J-HeartMate Risk Score (J-HMRS). Methods and Results: Of the 559 patients who underwent CRT at Tokyo Women's Medical University between 2000 and 2018, 198 were aged 65-75 years. Among these, 76 were identified as non-responders based on echocardiographic data, and were included in this study. We calculated patients' J-HMRS and investigated associations between the J-HMRS and cardiac events after CRT. Patients were divided into 3 groups according to the J-HMRS: low (n=23), medium (n=29), and high (n=24) risk. Patients in the low-risk group experienced as many HF rehospitalizations and ventricular arrhythmia events as those in the other groups. However, survival analysis revealed that, after CRT, survival was higher for patients in the low- compared with high-risk group (P=0.04). Conclusions: The J-HMRS classified 30% of elderly CRT non-responders as low risk and as suitable candidates for DT in Japan.
DOI 10.1253/circrep.CR-22-0074
PMID 36120479