Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia
The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricular arrhythmias (VA) is still dis...
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| creator | Eickholt, Christian Siekiera, Marcus Kirmanoglou, Kiriakos Rodenbeck, Astrid Heussen, Nicole Schauerte, Patrick Lichtenberg, Artur Balzer, Jan Rassaf, Tienush Perings, Stefan Kelm, Malte Shin, Dong-In Meyer, Christian |
| description | The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricular arrhythmias (VA) is still discussed controversially. Therefore, we investigated the incidence of VA in CRT responders in comparison with non-responders.
In this nonrandomized, two-center, observational study patients with moderate-to-severe heart failure, LV ejection fraction (LVEF) ≤35%, and QRS duration >120 ms undergoing CRT were included. After 6 months patients were classified as CRT responders or non-responders. Incidence of VA was compared between both groups by Kaplan-Meier analysis and Cox regression analysis. ROC analysis was performed to determine the aptitude of LVEF cut-off values to predict VA.
In total 126 consecutive patients (64±11 years; 67%male) were included, 74 were classified as responders and 52 as non-responders. While the mean LVEF at baseline was comparable in both groups (25±7% vs. 24±8%; P = 0.4583) only the responder group showed an improvement of LVEF (36±6% vs. 24±7; p |
| doi_str_mv | 10.1371/journal.pone.0048926 |
| format | Article |
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In this nonrandomized, two-center, observational study patients with moderate-to-severe heart failure, LV ejection fraction (LVEF) ≤35%, and QRS duration >120 ms undergoing CRT were included. After 6 months patients were classified as CRT responders or non-responders. Incidence of VA was compared between both groups by Kaplan-Meier analysis and Cox regression analysis. ROC analysis was performed to determine the aptitude of LVEF cut-off values to predict VA.
In total 126 consecutive patients (64±11 years; 67%male) were included, 74 were classified as responders and 52 as non-responders. While the mean LVEF at baseline was comparable in both groups (25±7% vs. 24±8%; P = 0.4583) only the responder group showed an improvement of LVEF (36±6% vs. 24±7; p<0.0001) under CRT. In total in 56 patients VA were observed during a mean follow-up of 28±14 months, with CRT responders experiencing fewer VA than non-responders (35% vs. 58%, p<0.0061). Secondary preventive CRT implantation was associated with a higher likelihood of VA. As determined by ROC analysis an increase of LVEF by >7% was found to be a predictor of a significantly lower incidence of VA (AUC = 0.606).
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0048926</identifier><identifier>PMID: 23152822</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aptitude ; Arrhythmia ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - mortality ; Arrhythmias, Cardiac - physiopathology ; Arrhythmias, Cardiac - therapy ; Beta blockers ; Biology ; Cardiac arrhythmia ; Cardiac Resynchronization Therapy ; Cardiology ; Defibrillators ; Female ; Follow-Up Studies ; Heart ; Heart diseases ; Heart failure ; Heart Failure - complications ; Heart Failure - therapy ; Humans ; Implantation ; Incidence ; Male ; Medical prognosis ; Medical research ; Medicine ; Middle Aged ; Mortality ; Patients ; Regression analysis ; ROC Curve ; Stroke Volume ; Therapy ; Treatment Outcome ; Ventricle ; Ventricular Function, Left ; Ventricular Remodeling</subject><ispartof>PloS one, 2012-11, Vol.7 (11), p.e48926-e48926</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Eickholt et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2012 Eickholt et al 2012 Eickholt et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-af7a307eb5b34beed7c5306fbd9d98785acc307381e1373f6239d7e5d93de33c3</citedby><cites>FETCH-LOGICAL-c692t-af7a307eb5b34beed7c5306fbd9d98785acc307381e1373f6239d7e5d93de33c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495960/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495960/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23152822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eickholt, Christian</creatorcontrib><creatorcontrib>Siekiera, Marcus</creatorcontrib><creatorcontrib>Kirmanoglou, Kiriakos</creatorcontrib><creatorcontrib>Rodenbeck, Astrid</creatorcontrib><creatorcontrib>Heussen, Nicole</creatorcontrib><creatorcontrib>Schauerte, Patrick</creatorcontrib><creatorcontrib>Lichtenberg, Artur</creatorcontrib><creatorcontrib>Balzer, Jan</creatorcontrib><creatorcontrib>Rassaf, Tienush</creatorcontrib><creatorcontrib>Perings, Stefan</creatorcontrib><creatorcontrib>Kelm, Malte</creatorcontrib><creatorcontrib>Shin, Dong-In</creatorcontrib><creatorcontrib>Meyer, Christian</creatorcontrib><title>Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricular arrhythmias (VA) is still discussed controversially. Therefore, we investigated the incidence of VA in CRT responders in comparison with non-responders.
In this nonrandomized, two-center, observational study patients with moderate-to-severe heart failure, LV ejection fraction (LVEF) ≤35%, and QRS duration >120 ms undergoing CRT were included. After 6 months patients were classified as CRT responders or non-responders. Incidence of VA was compared between both groups by Kaplan-Meier analysis and Cox regression analysis. ROC analysis was performed to determine the aptitude of LVEF cut-off values to predict VA.
In total 126 consecutive patients (64±11 years; 67%male) were included, 74 were classified as responders and 52 as non-responders. While the mean LVEF at baseline was comparable in both groups (25±7% vs. 24±8%; P = 0.4583) only the responder group showed an improvement of LVEF (36±6% vs. 24±7; p<0.0001) under CRT. In total in 56 patients VA were observed during a mean follow-up of 28±14 months, with CRT responders experiencing fewer VA than non-responders (35% vs. 58%, p<0.0061). Secondary preventive CRT implantation was associated with a higher likelihood of VA. As determined by ROC analysis an increase of LVEF by >7% was found to be a predictor of a significantly lower incidence of VA (AUC = 0.606).
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia.</description><subject>Aged</subject><subject>Aptitude</subject><subject>Arrhythmia</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Arrhythmias, Cardiac - mortality</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Arrhythmias, Cardiac - therapy</subject><subject>Beta blockers</subject><subject>Biology</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Resynchronization Therapy</subject><subject>Cardiology</subject><subject>Defibrillators</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Implantation</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>ROC Curve</subject><subject>Stroke Volume</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><subject>Ventricular 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arrhythmia</topic><topic>Cardiac Resynchronization Therapy</topic><topic>Cardiology</topic><topic>Defibrillators</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Implantation</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>ROC Curve</topic><topic>Stroke Volume</topic><topic>Therapy</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eickholt, Christian</creatorcontrib><creatorcontrib>Siekiera, 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One</addtitle><date>2012-11-12</date><risdate>2012</risdate><volume>7</volume><issue>11</issue><spage>e48926</spage><epage>e48926</epage><pages>e48926-e48926</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricular arrhythmias (VA) is still discussed controversially. Therefore, we investigated the incidence of VA in CRT responders in comparison with non-responders.
In this nonrandomized, two-center, observational study patients with moderate-to-severe heart failure, LV ejection fraction (LVEF) ≤35%, and QRS duration >120 ms undergoing CRT were included. After 6 months patients were classified as CRT responders or non-responders. Incidence of VA was compared between both groups by Kaplan-Meier analysis and Cox regression analysis. ROC analysis was performed to determine the aptitude of LVEF cut-off values to predict VA.
In total 126 consecutive patients (64±11 years; 67%male) were included, 74 were classified as responders and 52 as non-responders. While the mean LVEF at baseline was comparable in both groups (25±7% vs. 24±8%; P = 0.4583) only the responder group showed an improvement of LVEF (36±6% vs. 24±7; p<0.0001) under CRT. In total in 56 patients VA were observed during a mean follow-up of 28±14 months, with CRT responders experiencing fewer VA than non-responders (35% vs. 58%, p<0.0061). Secondary preventive CRT implantation was associated with a higher likelihood of VA. As determined by ROC analysis an increase of LVEF by >7% was found to be a predictor of a significantly lower incidence of VA (AUC = 0.606).
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23152822</pmid><doi>10.1371/journal.pone.0048926</doi><tpages>e48926</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Aptitude Arrhythmia Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - mortality Arrhythmias, Cardiac - physiopathology Arrhythmias, Cardiac - therapy Beta blockers Biology Cardiac arrhythmia Cardiac Resynchronization Therapy Cardiology Defibrillators Female Follow-Up Studies Heart Heart diseases Heart failure Heart Failure - complications Heart Failure - therapy Humans Implantation Incidence Male Medical prognosis Medical research Medicine Middle Aged Mortality Patients Regression analysis ROC Curve Stroke Volume Therapy Treatment Outcome Ventricle Ventricular Function, Left Ventricular Remodeling |
| title | Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T16%3A17%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Improvement%20of%20left%20ventricular%20function%20under%20cardiac%20resynchronization%20therapy%20goes%20along%20with%20a%20reduced%20incidence%20of%20ventricular%20arrhythmia&rft.jtitle=PloS%20one&rft.au=Eickholt,%20Christian&rft.date=2012-11-12&rft.volume=7&rft.issue=11&rft.spage=e48926&rft.epage=e48926&rft.pages=e48926-e48926&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0048926&rft_dat=%3Cgale_plos_%3EA477091391%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1335057310&rft_id=info:pmid/23152822&rft_galeid=A477091391&rft_doaj_id=oai_doaj_org_article_12e5778a6cd94da08e0a267e312afc79&rfr_iscdi=true |