Cardiac Resynchronization and Quality of Life in Patients With Minimally Symptomatic Heart Failure

Veazie, Peter J.; Noyes, Katia; Li, Qinghua; Hall, William J.; Buttaccio, April; Thevenet-Morrison, Kelly; Moss, Arthur J.

doi:10.1016/j.jacc.2012.06.054

Cited by 50 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…26 There better than defibrillator alone and 2 points better in cohort with left bundle branch block. 28 The Placement of Aortic Transcatheter Valve (PARTNERS) trial evaluated transcutaneous aortic valve replacement versus surgical aortic valve replacement and demonstrated significant improvements in KCCQ at 1 month with a 5.5 point difference, but there were no differences at 6 or 12 months. 29 The addition of surgical ventricular restoration to bypass surgery did not result in significant difference between KCCQ change scores in comparison to bypass alone in The Surgical Treatment for Ischemic Heart Failure (STICH).…”

Section: Discussionmentioning

confidence: 99%

Impact of Spironolactone on Longitudinal Changes in Health-Related Quality of Life in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial

Lewis

Kim

Claggett

et al. 2016

Circ: Heart Failure

View full text Add to dashboard Cite

Background— Heart failure (HF) with preserved ejection fraction patients have equally impaired health-related quality of life (HRQL) compared with those with HF with reduced ejection fraction, but limited studies have evaluated the impact of therapies on changes in HRQL. Methods and Results— Patients ≥50 years of age, with symptomatic HF and left ventricular ejection fraction ≥45%, were enrolled in Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) and randomized to spironolactone or placebo. Patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ), which was the primary HRQL instrument, and EQ5D visual analog scale at baseline, 4 months, 12 months, and annually thereafter. McMaster Overall Treatment Evaluation was assessed at 4 and 12 months to assess global change scores. Change scores (+SD) were calculated to determine between-group differences, and multivariable repeated-measures models were created to identify other factors associated with change scores. Paired KCCQ data were available for 91.7% of 3445 TOPCAT patients. By 4 months, the mean change in KCCQ was 7.7±16 and mean change in EQ5D visual analog scale was 4.7±16. Adjusted mean changes in KCCQ for the spironolactone group were significantly better than those for the placebo group at 4-month (1.54 better; P =0.002), 12-month (1.35 better; P =0.02), and 36-month (1.86 better; P =0.02) visits. No between-group differences in EQ5D visual analog scale change scores or McMaster Overall Treatment Evaluation were noted. Older age, obesity, current smoking, New York Heart Association class III/IV, and comorbid illnesses were associated with declines in KCCQ scores. Use of spironolactone was an independent predictor of improved KCCQ scores. Conclusions— In symptomatic HF with preserved ejection fraction patients, use of spironolactone was associated with an improvement in HF-specific HRQL. Several modifiable risk factors were associated with HRQL deterioration. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00094302.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Spironolactone on Longitudinal Changes in Health-Related Quality of Life in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial

Lewis

Kim

Claggett

et al. 2016

Circ: Heart Failure

View full text Add to dashboard Cite

show abstract

“…Several studies have also shown its benefit in mild to moderate heart failure. [16][17][18][19][20] Since US Food and Drug Administration (FDA) approval for use in advanced heart failure in the United States in 2001, the use of CRT has steadily increased. 21 To our knowledge, this is the first characterization of trends in utilization of CRT in the United States.…”

mentioning

confidence: 99%

Cardiac Resynchronization Therapy

Sridhar

Yarlagadda

Parasa

et al. 2016

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Background-The use of cardiac resynchronization therapy (CRT) has increased significantly since its initial approval in 2001 for use in patients with advanced heart failure. However, trends in utilization of CRT have not been systematically characterized. Methods and Results-We used the Nationwide Inpatient Sample database to identify all patients with CRT implantation during 2002 to 2010. The overall trends in CRT device implantation, patient characteristics, and outcomes were examined in detail and compared among demographic subgroups. During 2002 to 2010, a total of 374 202 CRT procedures were recorded. Significant and persistent gender and racial disparities favoring men (71.4%) and white (79.6%), respectively, were noted in all years. The highest number of CRT devices were implanted in the 65-to 84-year age group (64.6%), with significant increase in number of CRT implants in older patients ≥85 years over the years (P=0.02). The CRT-associated in-hospital mortality improved from 1.08% in 2003 to 0.70% in 2010 (P=0.03). The correlates of higher mortality included males (0.93% versus 0.71% in females; P=0.04) and older age (age ≥85 years had 1.5% mortality versus 0.8% for age <85 year; P<0.001). The mean hospital length of stay for CRT decreased, while mean CRT-associated hospital charges increased progressively over the years. Factors associated with higher charges were gender (males>females), older age, and greater comorbidities. Conclusions-CRT implantation is a relatively safe procedure that has become safer in higher risk patients. However, significant disparities in CRT utilization exist in certain demographic subgroups, and these disparities have persisted across the years. (Circ Arrhythm Electrophysiol. 2016;9:e003108.

show abstract

“…The beneit of CRT in mild to moderate heart failure has also been demonstrated by several studies [19][20][21][22][23]. Long-term beneicial efects on left ventricular function were shown by positron emission tomography evaluations, and CRT enhances myocardial forward work eiciency at rest in patients with dilated cardiomyopathy and heart failure [24,25].…”

Section: Mechanism Of Crtmentioning

confidence: 77%

The Impact of Cardiac Resynchronization Therapy in the Treatment of Heart Failure

Murashita¹

2017

The Role of the Clinical Cardiac Electrophysiologist in the Management of Congestive Heart Failure

View full text Add to dashboard Cite

The number of patients who sufer from heart failure is rapidly increasing. In about onethird of heart failure patients, conduction delays cause dyssynchronous left ventricular contractions, which leads to reduction in left ventricular function, adverse cardiac remodelling and inally increased mortality. Cardiac resynchronization involves simultaneous pacing of both ventricles, and improves left ventricular contractile function. Although resynchronization does not restore myocardial function, multiple studies have shown that cardiac resynchronization therapy improves quality of life, exercise capacity, symptoms of heart failure, left ventricular ejection fraction, morbidity and mortality. The use of cardiac resynchronization therapy has increased signiicantly, since its initial approval in 2001, in patients with advanced heart failure.Keywords: heart failure, cardiac resynchronization therapy, electrophysiologist, left bundle branch block, left ventricular function IntroductionThe number of patients who sufer from chronic heart failure is rapidly growing. According to the 2016 update on heart disease and stroke statistics reported by the American Heart Association, an estimated 5.7 million Americans ≥20 years of age have a diagnosis of heart failure and projections show that the prevalence of heart failure will increase 46% from 2012 to 2030, resulting in >8 million people ≥18 years of age with heart failure [1]. In the year of 2013, heart failure was the underlying cause in >65,000 deaths and contributed to the death of >300,000 people [1]. In the same report, there is an estimate that a total cost of over $30 billion was used for the treatment of heart failure in 2012 [1]. Direct medical costs atributed to 68% of this total amount. The lifetime risk of developing heart failure is 20% for adults at the © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.age of 40 years and goes up with age. Acute heart failure consists of one of the most common reasons for hospitalization, atributing to over 1 million discharges annually and high 30-day readmission rates (up to 25%) and 1 year (up to 60%) [1]. The prognosis for heart failure is poor, with an estimated mortality rate of 50% within 5 years of diagnosis. Cardiac resynchronization therapy (CRT) Advent of CRTAn intraventricular conduction delay is found in approximately 20-30% of patients with symptomatic heart failure. Conduction delay causes dyssynchronous left ventricular contractions, which lead to left ventricular dysfunction, adverse cardiac remodelling and eventually high mortality [2][3][4]. Conduction delay may also lead to mitral valve regurgitation, thus increasing symptoms of heart failure. The prevalence of left ventricular dyssynchrony in heart failure has been shown to increase with reduced left ventricul...

show abstract

Cardiac Resynchronization and Quality of Life in Patients With Minimally Symptomatic Heart Failure

Abstract: Compared with patients with ICD only, CRT-ICD is associated with greater improvement in QOL among relatively asymptomatic patients, specifically among those with left bundle branch conduction disturbance.

Cited by 50 publications

References 17 publications

Impact of Spironolactone on Longitudinal Changes in Health-Related Quality of Life in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial

Impact of Spironolactone on Longitudinal Changes in Health-Related Quality of Life in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial

Cardiac Resynchronization Therapy

The Impact of Cardiac Resynchronization Therapy in the Treatment of Heart Failure

Contact Info

Product

Resources

About