Echocardiographic and Electrical Reverse Remodeling in Cardiac Resynchronization Therapy

Fernández-Pastor, Julia; Cabrera-Bueno, Fernando; Linde-Estrella, Antonio L.; Peña-Hernández, José; Barrera-Cordero, Alberto; Alzueta-Rodríguez, Javier

doi:10.1016/j.rec.2011.08.016

Cited by 2 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Forty‐two studies fulfilled the search criteria (Supporting Information, Table ) 5,7–47 . Two of them evaluated exclusively AR, 46,47 and two other studies assessed AR together with RR 8,9 .…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

et al. 2021

View full text Add to dashboard Cite

Aims Reverse remodelling (RR) is the recovery from left ventricular (LV) dilatation and dysfunction. Many arbitrary criteria for RR have been proposed. We searched the criteria with the strongest prognostic yield for the hard endpoint of cardiovascular death. Methods and resultsWe performed a systematic literature search of diagnostic criteria for RR. We evaluated their prognostic significance in a cohort of 927 patients with LV ejection fraction (LVEF) < 50% undergoing two echocardiograms within 12 ± 2 months. These patients were followed for a median of 2.8 years (interquartile interval 1.3-4.9) after the second echocardiogram, recording 123 cardiovascular deaths. Two prognostic models were defined. Model 1 included age, LVEF, N-terminal pro-B-type natriuretic peptide, ischaemic aetiology, cardiac resynchronization therapy, estimated glomerular filtration rate, New York Heart Association, and LV end-systolic volume (LVESV) index, and Model 2 the validated Cardiac and Comorbid Conditions Heart Failure score. We identified 25 criteria for RR, the most used being LVESV reduction ≥15% (12 studies out of 42). In the whole cohort, two criteria proved particularly effective in risk reclassification over Model 1 and Model 2. These criteria were (i) LVEF increase >10 U and (ii) LVEF increase ≥1 category [severe (LVEF ≤ 30%), moderate (LVEF 31-40%), mild LV dysfunction (LVEF 41-55%), and normal LV function (LVEF ≥ 56%)]. The same two criteria yielded independent prognostic significance and improved risk reclassification even in patients with more severe systolic dysfunction, namely, those with LVEF < 40% or LVEF ≤ 35%. Furthermore, LVEF increase >10 U and LVEF increase ≥1 category displayed a greater prognostic value than LVESV reduction ≥15%, both in the whole cohort and in the subgroups with LVEF < 40% or LVEF ≤ 35%. For example, LVEF increase >10 U independently predicted cardiovascular death over Model 1 and LVESV reduction ≥15% (hazard ratio 0.40, 95% confidence interval 0.18-0.90, P = 0.026), while LVESV reduction ≥15% did not independently predict cardiovascular death (P = 0.112). Conclusions Left ventricular ejection fraction increase >10 U and LVEF increase ≥1 category are stronger predictors of cardiovascular death than the most commonly used criterion for RR, namely, LVESV reduction ≥15%.

show abstract

Section: Resultsmentioning

confidence: 99%

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Many studies define the relationship between a reduction in left ventricular end-systolic volume of at least 10% and a reduction in the width of the non-stimulated QRS (from 163 to 153 ms) and the stimulated QRS after implantation (from 146 to 121 ms) [26]. These data point at the same direction that those from other studies [27] and heighten the importance of placing the left ventricular electrode in the appropriate site and of properly programming the device, to achieve a narrow-paced QRS complex.…”

Section: Relationship Between Mechanical and Electrical Resynchronizamentioning

confidence: 99%

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Ángel¹,

Alfonso²,

Ángeles³

2017

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

View full text Add to dashboard Cite

Heart failure affects a high percentage of the population, especially older patients. Cardiac resynchronization therapy is indicated in some patients with advanced heart failure. However, 20-40% of patients with implanted resynchronization device have no clinical response. In this chapter, we review factors related with the absence of a clinical response, recent technological advances that can reduce the failure rate, and an algorithm for management of patients without a clinical response.

show abstract

Echocardiographic and Electrical Reverse Remodeling in Cardiac Resynchronization Therapy

Cited by 2 publications

References 8 publications

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Contact Info

Product

Resources

About