Functional and clinical implications of cardiac resynchronization therapy on outcomes of diabetic patients with heart failure.

Aims To compare functional and structural changes of the left ventricle and long-term clinical outcomes in diabetic and nondiabetic patients with heart failure undergoing cardiac resynchronization therapy (CRT). Methods Sixty-eight patients with heart failure undergoing CRT were included: 18 were diabetic patients and 50 nondiabetic patients. The CRT eligibility was established by echocardiographic assessments. Results CRT improved ventricular geometry and dyssynchrony in both diabetic and nondiabetic patients, with no significant difference in the magnitude of the effects on the left ventricular function. Over a median follow-up of 30.6 +/- 6.2 months, there were no significant differences in the rates of any cause death (16.7 vs. 14.0%, P=0.72), cardiac death (11.1 vs. 8.0%, P=0.65) and heart rehospitalization (5.6 vs. 6.0%, P=1.0), between diabetic and nondiabetic patients, respectively. Diabetes was not found to be an independent factor associated with worse clinical outcome. Conclusion Resynchronization therapy provided significant functional and hemodynamic improvements in both diabetic and nondiabetic patients. Long-term prognosis in heart failure patients with diabetes was comparable with that in those without diabetes