Foley, Paul W X and Stegemann, Berthold and Smith, Russell E A and Sanderson, John E and Leyva, Francisco (2009) Cardiac resynchronization therapy in patients with mildly impaired left ventricular function. Pacing and clinical electrophysiology : PACE, 32 Sup. S186-9. ISSN 1540-8159. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDsFull text not available from this repository.
We sought to determine the unknown effects of cardiac resynchronization therapy (CRT) in patients with a left ventricular ejection fraction (LVEF) >35%. Because of its technical limitations, echocardiography (Echo) may underestimate LVEF, compared with cardiovascular magnetic resonance (CMR).
Of 157 patients undergoing CRT (New York Heart Association [NYHA] functional class III or IV, QRS > or = 120 ms), all of whom had a preimplant Echo-LVEF < or =35%, 130 had a CMR-LVEF < or =35% (Group A, 19.7 +/- 7.0%[mean +/- standard deviation]) and 27 had a CMR-LVEF >35% (Group B, 43.6 +/- 7.7%). All patients underwent a CMR scan at baseline and a clinical evaluation, including a 6-minute walk test and a quality of life questionnaire, at baseline and after CRT.
Both groups derived similar improvements in NYHA functional class (A =-1.3, B =-1.2, [mean]), quality of life scores (A =-21.6, B =-33.0; all P < 0.0001 for changes from baseline), and 6-minute walking distance (A = 64.5, B = 70.1 m; P < 0.001 and P < 0.0001, respectively). Symptomatic response rates (increase by > or =1 NYHA classes or 25% 6-minute walking distance) were 79% in group A and 92% in group B. Over a maximum follow-up period of 5.9 years for events, patients in group A were at a higher risk of death from any cause, hospitalization for major cardiovascular events (P = 0.0232), or cardiovascular death (P = 0.0411). There were borderline differences in the risk of death from any cause (P = 0.0664) and cardiovascular death or hospitalization for heart failure (P = 0.0526).
This observational study suggests that the benefits of CRT extend to patients with a LVEF > 35%.
|Additional Information:||This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs|
|Subjects:||WG Cardiovascular system. Cardiology|
|Divisions:||Emergency Services > Cardiology|
|Depositing User:||Sophie Rollason|
|Date Deposited:||10 Jun 2014 13:29|
|Last Modified:||10 Jun 2014 13:29|
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