Abstract 4143109: Association Between Frailty Testing through Timed Up-and-Go Test Time and Mortality in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

Background: The use of cardiac resynchronization therapy (CRT) devices has significantly increased in usage in recent years. Identifying predictors of mortality in CRT patients remains an area of investigation. Objective: To establish a relationship between timed up-and-go test time (TUGT) and mortality in heart failure patients (HF) with CRT devices. Methods: This retrospective study included 506 patients with heart failure with reduced ejection fraction (HFrEF) who underwent CRT implantation at our institution between 2017-2022. All patients were followed up with a multidisciplinary team, including electrophysiology and HF physicians about 6 months after CRT implantation, where frailty was assessed. We used TUGT as a measure of frailty and divided patients into 2 groups: TUGT: >15 seconds (n=73) and ≤15 seconds (n=433). The primary endpoint was a composite of left ventricular assist device implantation, transplant, or death at 2 years post-CRT. Data was collected retrospectively from electronic medical records. Results: The study population was 65.6% male, with a mean age of 69.1 years, and 79.4% of devices being CRT-D.Response was defined as an improvement in LVEF >5% with reduction in LVESV>10%; anybody not meeting this definition was classified as a non-responder. Responder and non-responder rates among TUGT >15 and TUGT < 15 were 60.3% vs 69.3%; and 39.7% vs 30.7%, respectively. The median (IQR) timed up and go time was 9.25s (7.48-11.7s). 52 (10.3%) patients had a composite outcome within 2 years follow up. Univariate analysis revealed that higher TUGT was significantly associated with worse outcomes (median TUGT 9.07 vs 11.9s; p<0.001). Multivariate cox regression also revealed TUGT>15s to be an independent predictor of our composite outcome [HR= 3.47 (1.71-7.06); p=0.001] (Table 1), with adjusted survival curves showing patients with TUGT>15s have worse outcomes (Figure 1). Conclusion: Frailty testing using TUGT post-CRT implantation is a strong predictor of mortality in HFrEF patients after CRT implantation.