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Abstract：
Heart failure (HF) is a leading cause of mortality and hospitalization in the elderly. However, data are scarce about their response to device treatment such as cardiac resynchronization therapy (CRT). We aimed to evaluate the age-related differences in the effectiveness of CRT, procedure-related complications, and long-term outcome. Between 2000 and 2020, 2656 patients undergoing CRT implantation were registered and analyzed retrospectively. Patients were divided into 3 groups according to their age: group I, < 65; group II, 65-75; and group III, > 75 years. The primary endpoint was the echocardiographic response defined as a relative increase > 15% in left ventricular ejection fraction (LVEF) within 6 months, and the secondary endpoint was the composite of all-cause mortality, heart transplantation, or left ventricular assist device implantation. Procedure-related complications were also assessed. After implantation, LVEF showed significant improvement both in the total cohort [28% (IQR 24/33) vs. 35% (IQR 28/40); p < 0.01)] and in each subgroup (27% vs. 34%; p < 0.01, 29% vs. 35%; p < 0.01, 30% vs. 35%; p < 0.01). Response rate was similar in the 3 groups (64% vs. 62% vs. 56%; p = 0.41). During the follow-up, 1574 (59%) patients died. Kaplan-Meier curves revealed a significantly lower survival rate in the older groups (log-rank p < 0.001). The cumulative complication rates were similar among the three age groups (27% vs. 28% vs. 24%; p = 0.15). Our results demonstrate that CRT is as effective and safe therapy in the elderly as for young ones. The present data suggest that patients with appropriate indications benefit from CRT in the long term, regardless of age.
摘要：
心力衰竭(HF)是老年人死亡和住院的主要原因。然而,关于他们对心脏再同步治疗(CRT)等器械治疗反应的数据很少.我们旨在评估与年龄相关的CRT效果差异，手术相关并发症,和长期的结果。在2000年至2020年之间，对2656例接受CRT植入的患者进行了登记和回顾性分析。患者根据年龄分为3组：I组，<65；第二组，65-75；和第三组，>75年。主要终点是超声心动图反应，定义为6个月内左心室射血分数（LVEF）的相对增加>15％，次要终点是全因死亡率，心脏移植,或左心室辅助装置植入。还评估了手术相关的并发症。植入后,LVEF在总队列中均显示出显着改善[28％（IQR24/33）与35％（IQR28/40）；p<0.01）]和每个亚组（27％vs.34%；p<0.01，29%vs.35%；p<0.01，30%vs.35%；p<0.01)。3组的反应率相似(64%vs.62%vs.56%；p=0.41）。在后续行动中,1574例（59%）患者死亡。Kaplan-Meier曲线显示，老年组的生存率明显降低（log-rankp<0.001）。三个年龄组的累积并发症发生率相似(27%vs.28%vs.24%；p=0.15）。我们的结果表明，CRT对老年人和年轻人一样有效和安全。目前的数据表明，有适当适应症的患者长期受益于CRT，不管年龄。
