Impact of ejection fraction on the clinical response to cardiac resynchronization therapy in mild heart failure
Current guidelines recommend cardiac resynchronization therapy (CRT) in mild heart failure (HF) patients with QRS prolongation and ejection fraction (EF) ≤30%. To assess the effect of CRT in less severe systolic dysfunction, outcomes in the REsynchronization reVErses Remodeling in Systolic left vEnt...
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| Veröffentlicht in: | Circulation. Heart failure 2013-11, Vol.6 (6), p.1180-1189 |
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| creator | Linde, Cecilia Daubert, Claude Abraham, William T St John Sutton, Martin Ghio, Stefano Hassager, Christian Herre, John M Bergemann, Tracy L Gold, Michael R |
| description | Current guidelines recommend cardiac resynchronization therapy (CRT) in mild heart failure (HF) patients with QRS prolongation and ejection fraction (EF) ≤30%. To assess the effect of CRT in less severe systolic dysfunction, outcomes in the REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) study were evaluated in which patients with left ventricular (LV) ejection fraction (LVEF) >30% were included.
The results of patients with baseline EF >30% (n=177) and those with EF ≤30% (n=431), as determined by a blinded core laboratory, were compared. In the LVEF >30% subgroup, there was a trend for improvement in the clinical composite response with CRT ON versus CRT OFF (P=0.06) and significant reductions in LV end systolic volume index (-6.7 ± 21.1 versus 2.1 ± 17.6 mL/m(2); P=0.01) and LV mass (-20.6 ± 50.5 versus 5.0 ± 42.4 g; P=0.04) after 12 months. The time to death or first HF hospitalization was significantly prolonged with CRT (hazard ratio, 0.26; P=0.012). In the LVEF 30%, CRT produced reverse remodeling and similar clinical benefit compared with subjects with more severe LV systolic dysfunction.
http://www.clinicaltrials.gov. Unique identifier: NCT00271154. |
| doi_str_mv | 10.1161/CIRCHEARTFAILURE.113.000326 |
| format | Article |
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The results of patients with baseline EF >30% (n=177) and those with EF ≤30% (n=431), as determined by a blinded core laboratory, were compared. In the LVEF >30% subgroup, there was a trend for improvement in the clinical composite response with CRT ON versus CRT OFF (P=0.06) and significant reductions in LV end systolic volume index (-6.7 ± 21.1 versus 2.1 ± 17.6 mL/m(2); P=0.01) and LV mass (-20.6 ± 50.5 versus 5.0 ± 42.4 g; P=0.04) after 12 months. The time to death or first HF hospitalization was significantly prolonged with CRT (hazard ratio, 0.26; P=0.012). In the LVEF <30% subgroup, significant improvements in clinical composite response (P=0.02), reverse remodeling parameters, and time to death or first HF hospitalization (hazard ratio, 0.58; P=0.047) were observed. After adjusting for important covariates, the CRT ON assignment remained independently associated with improved time to death or first HF hospitalization (hazard ratio, 0.54; P=0.035), whereas there was no significant interaction with LVEF.
Among subjects with mild HF, QRS prolongation, and LVEF >30%, CRT produced reverse remodeling and similar clinical benefit compared with subjects with more severe LV systolic dysfunction.
http://www.clinicaltrials.gov. Unique identifier: NCT00271154.</description><identifier>ISSN: 1941-3289</identifier><identifier>EISSN: 1941-3297</identifier><identifier>DOI: 10.1161/CIRCHEARTFAILURE.113.000326</identifier><identifier>PMID: 24014828</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Cardiac Resynchronization Therapy - methods ; Cardiology and cardiovascular system ; Double-Blind Method ; Europe - epidemiology ; Female ; Follow-Up Studies ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart Failure - therapy ; Human health and pathology ; Humans ; Life Sciences ; Male ; Middle Aged ; North America - epidemiology ; Prognosis ; Prospective Studies ; Severity of Illness Index ; Stroke Volume - physiology ; Survival Rate - trends ; Ventricular Function, Left - physiology ; Ventricular Remodeling - physiology</subject><ispartof>Circulation. Heart failure, 2013-11, Vol.6 (6), p.1180-1189</ispartof><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-20bea7e22293ca56385f81f6509022c4b35018ac8ca5bc344eb3e3d3f6a3ed5a3</citedby><cites>FETCH-LOGICAL-c446t-20bea7e22293ca56385f81f6509022c4b35018ac8ca5bc344eb3e3d3f6a3ed5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24014828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-rennes.hal.science/hal-01154221$$DView record in HAL$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:128550601$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Linde, Cecilia</creatorcontrib><creatorcontrib>Daubert, Claude</creatorcontrib><creatorcontrib>Abraham, William T</creatorcontrib><creatorcontrib>St John Sutton, Martin</creatorcontrib><creatorcontrib>Ghio, Stefano</creatorcontrib><creatorcontrib>Hassager, Christian</creatorcontrib><creatorcontrib>Herre, John M</creatorcontrib><creatorcontrib>Bergemann, Tracy L</creatorcontrib><creatorcontrib>Gold, Michael R</creatorcontrib><creatorcontrib>REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) Study Group</creatorcontrib><title>Impact of ejection fraction on the clinical response to cardiac resynchronization therapy in mild heart failure</title><title>Circulation. Heart failure</title><addtitle>Circ Heart Fail</addtitle><description>Current guidelines recommend cardiac resynchronization therapy (CRT) in mild heart failure (HF) patients with QRS prolongation and ejection fraction (EF) ≤30%. To assess the effect of CRT in less severe systolic dysfunction, outcomes in the REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) study were evaluated in which patients with left ventricular (LV) ejection fraction (LVEF) >30% were included.
The results of patients with baseline EF >30% (n=177) and those with EF ≤30% (n=431), as determined by a blinded core laboratory, were compared. In the LVEF >30% subgroup, there was a trend for improvement in the clinical composite response with CRT ON versus CRT OFF (P=0.06) and significant reductions in LV end systolic volume index (-6.7 ± 21.1 versus 2.1 ± 17.6 mL/m(2); P=0.01) and LV mass (-20.6 ± 50.5 versus 5.0 ± 42.4 g; P=0.04) after 12 months. The time to death or first HF hospitalization was significantly prolonged with CRT (hazard ratio, 0.26; P=0.012). In the LVEF <30% subgroup, significant improvements in clinical composite response (P=0.02), reverse remodeling parameters, and time to death or first HF hospitalization (hazard ratio, 0.58; P=0.047) were observed. After adjusting for important covariates, the CRT ON assignment remained independently associated with improved time to death or first HF hospitalization (hazard ratio, 0.54; P=0.035), whereas there was no significant interaction with LVEF.
Among subjects with mild HF, QRS prolongation, and LVEF >30%, CRT produced reverse remodeling and similar clinical benefit compared with subjects with more severe LV systolic dysfunction.
http://www.clinicaltrials.gov. Unique identifier: NCT00271154.</description><subject>Cardiac Resynchronization Therapy - methods</subject><subject>Cardiology and cardiovascular system</subject><subject>Double-Blind Method</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>North America - epidemiology</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Stroke Volume - physiology</subject><subject>Survival Rate - trends</subject><subject>Ventricular Function, Left - physiology</subject><subject>Ventricular Remodeling - physiology</subject><issn>1941-3289</issn><issn>1941-3297</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV9r2zAUxcXYWLtuX2EI9rI9uNNfx2ZPIaRNIDAI7bO4lq-JOtvyJLsj-_RT6iywwYV7OPqdq4dDyCfObjnP-dfVdr_arJf7h7vldve4XydX3jLGpMhfkWteKp5JUS5eX3RRXpF3MT4xlguty7fkSijGVSGKa-K33QB2pL6h-IR2dL6nTYBZpBkPSG3remehpQHj4PuIdPTUQqgd2JN37O0h-N79hpdUigQYjtT1tHNtTQ8IYaQNuHYK-J68aaCN-OG8b8jj3fphtcl23--3q-Uus0rlYyZYhbBAIUQpLehcFropeJNrVjIhrKqkZrwAW6THykqlsJIoa9nkILHWIG9INt-Nv3CYKjME10E4Gg_OnK0fSaHRYsEWIvFfZv4A7T_wZrkzJ49xrpUQ_Jkn9vPMDsH_nDCOpnPRYttCj36KhqucS8WZLhL6bUZt8DEGbC63OTOnNs3_bSZXmrnNlP54_miqOqwv2b_1yT-E656Z</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Linde, Cecilia</creator><creator>Daubert, Claude</creator><creator>Abraham, William T</creator><creator>St John Sutton, Martin</creator><creator>Ghio, Stefano</creator><creator>Hassager, Christian</creator><creator>Herre, John M</creator><creator>Bergemann, Tracy L</creator><creator>Gold, Michael R</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>20131101</creationdate><title>Impact of ejection fraction on the clinical response to cardiac resynchronization therapy in mild heart failure</title><author>Linde, Cecilia ; Daubert, Claude ; Abraham, William T ; St John Sutton, Martin ; Ghio, Stefano ; Hassager, Christian ; Herre, John M ; Bergemann, Tracy L ; Gold, Michael R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-20bea7e22293ca56385f81f6509022c4b35018ac8ca5bc344eb3e3d3f6a3ed5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Cardiac Resynchronization Therapy - methods</topic><topic>Cardiology and cardiovascular system</topic><topic>Double-Blind Method</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>North America - epidemiology</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Stroke Volume - physiology</topic><topic>Survival Rate - trends</topic><topic>Ventricular Function, Left - physiology</topic><topic>Ventricular Remodeling - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Linde, Cecilia</creatorcontrib><creatorcontrib>Daubert, Claude</creatorcontrib><creatorcontrib>Abraham, William T</creatorcontrib><creatorcontrib>St John Sutton, Martin</creatorcontrib><creatorcontrib>Ghio, Stefano</creatorcontrib><creatorcontrib>Hassager, Christian</creatorcontrib><creatorcontrib>Herre, John M</creatorcontrib><creatorcontrib>Bergemann, Tracy L</creatorcontrib><creatorcontrib>Gold, Michael R</creatorcontrib><creatorcontrib>REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Circulation. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Linde, Cecilia</au><au>Daubert, Claude</au><au>Abraham, William T</au><au>St John Sutton, Martin</au><au>Ghio, Stefano</au><au>Hassager, Christian</au><au>Herre, John M</au><au>Bergemann, Tracy L</au><au>Gold, Michael R</au><aucorp>REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of ejection fraction on the clinical response to cardiac resynchronization therapy in mild heart failure</atitle><jtitle>Circulation. Heart failure</jtitle><addtitle>Circ Heart Fail</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>6</volume><issue>6</issue><spage>1180</spage><epage>1189</epage><pages>1180-1189</pages><issn>1941-3289</issn><eissn>1941-3297</eissn><abstract>Current guidelines recommend cardiac resynchronization therapy (CRT) in mild heart failure (HF) patients with QRS prolongation and ejection fraction (EF) ≤30%. To assess the effect of CRT in less severe systolic dysfunction, outcomes in the REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) study were evaluated in which patients with left ventricular (LV) ejection fraction (LVEF) >30% were included.
The results of patients with baseline EF >30% (n=177) and those with EF ≤30% (n=431), as determined by a blinded core laboratory, were compared. In the LVEF >30% subgroup, there was a trend for improvement in the clinical composite response with CRT ON versus CRT OFF (P=0.06) and significant reductions in LV end systolic volume index (-6.7 ± 21.1 versus 2.1 ± 17.6 mL/m(2); P=0.01) and LV mass (-20.6 ± 50.5 versus 5.0 ± 42.4 g; P=0.04) after 12 months. The time to death or first HF hospitalization was significantly prolonged with CRT (hazard ratio, 0.26; P=0.012). In the LVEF <30% subgroup, significant improvements in clinical composite response (P=0.02), reverse remodeling parameters, and time to death or first HF hospitalization (hazard ratio, 0.58; P=0.047) were observed. After adjusting for important covariates, the CRT ON assignment remained independently associated with improved time to death or first HF hospitalization (hazard ratio, 0.54; P=0.035), whereas there was no significant interaction with LVEF.
Among subjects with mild HF, QRS prolongation, and LVEF >30%, CRT produced reverse remodeling and similar clinical benefit compared with subjects with more severe LV systolic dysfunction.
http://www.clinicaltrials.gov. Unique identifier: NCT00271154.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>24014828</pmid><doi>10.1161/CIRCHEARTFAILURE.113.000326</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation. Heart failure, 2013-11, Vol.6 (6), p.1180-1189 |
| issn | 1941-3289 1941-3297 |
| language | eng |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Cardiac Resynchronization Therapy - methods Cardiology and cardiovascular system Double-Blind Method Europe - epidemiology Female Follow-Up Studies Heart Failure - mortality Heart Failure - physiopathology Heart Failure - therapy Human health and pathology Humans Life Sciences Male Middle Aged North America - epidemiology Prognosis Prospective Studies Severity of Illness Index Stroke Volume - physiology Survival Rate - trends Ventricular Function, Left - physiology Ventricular Remodeling - physiology |
| title | Impact of ejection fraction on the clinical response to cardiac resynchronization therapy in mild heart failure |
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