Objective To observe the clinical effects of cardiac resynchronization therapy (CRT)in patients with chronic heart failure,and compare the clinical characteristics and outcome between responders and non-responders to define factors related to the efficacy of CRT.Methods We retrospectively analyzed the data of patients underwent CRT-P/D implantation from January 2006 to December 2012 in our Hospital.All patients received long-term follow-up including NYHA classification,left ventricular ejection fraction (LVEF) and left ventricular internal dimension at end diastole (LVIDd).Results A total of 204 patients were included (130 males,mean age (64.8 ± 11.9) years).The total response rate of CRT was 61.3％.Women,QRS duration ≥150 ms,and left bundle branch block (LBBB) were related with better response after CRT (all P ＜ 0.05).Multivariate regression analysis showed that QRS duration was an independent determinant for CRT response.All-cause mortality rate was significantly lower in responder group than in non-responder group (P ＜ 0.001).Conclusions In patients with chronic heart failure,women,QRS duration ≥ 150 ms,and LBBB are related with better CRT response rate post CRT.QRS duration ≥ 150 ms is an independent predictor of CRT response,and positive response is associated with lower all-cause mortality in this oatient cohort.

Background::The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods::This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results::Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively ( P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively ( P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.