Marked Improvement in Left Ventricular Function and Significant Reverse Left Ventricular Remodeling within 3 Months of Cardiac Resynchronization Therapy in Patients with Dilated Cardiomyopathy

Funck, R.; Koelsch, Susanne; Waldhans, S; Prinz, Helge; Grimm, Wolfram; Moosdorf, Rainer; Maisch, Bernhard

doi:10.1111/j.1540-8159.2005.00089.x

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…Two other patients did not present QRS narrowing, but both had clinical and echocardiographic improvements, albeit mild. Ventricular remodeling may occur even early in resynchronized patients (3 months after implantation) 20 , and is fundamental as a predictor of sustained clinical improvement 21 . Several clinical variables attempted to identify subgroups with possible favorable responses to resynchronization, however the findings were not uniform 22,23 .…”

Section: Discussionmentioning

confidence: 99%

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Rocha¹,

Gondim²,

Abreu³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjective: To analyze the conventional biventricular pacing (BV) and the bifocal (BF) right ventricular (RV) pacing, and to perform a comparative analysis of these two techniques in relation to clinical, functional and echocardiographic parameters in a population without the exclusion criteria of the major studies.Methods: A prospective non-randomized analysis of 36 patients undergoing surgery for multisite pacemaker implantation due to QRS ≥ 130 ms, severe left ventricular dysfunction, and NYHA functional class III or ambulatory class IV congestive heart failure was performed.Results: Favorable results of resynchronization were obtained with both techniques, with no significant differences in the comparison of the two groups, except for a higher QRS narrowing in the BV group, and a trend of a lower number or hospital admissions in the BV group. When the groups were analyzed separately and compared before and after the procedures, we observed that improvement was much more significant in the biventricular group, as were the more statistically relevant rates.Conclusion: Cardiac resynchronization therapy proved to be an efficient therapy in both groups analyzed, although with more significant outcomes in the biventricular group. (Arq Bras Cardiol 2007;88(6):596-603)

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Section: Discussionmentioning

confidence: 99%

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Rocha¹,

Gondim²,

Abreu³

et al. 2007

Arq. Bras. Cardiol.

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“…In einer Vielzahl von kleineren Studien und im CRT-Arm der MIRACLE-Studie konnte nun bereits gezeigt werden, dass CRT zu einem «reversen linksventrikulären remodeling» mit Verkleinerung der enddiastolischen und endsystolischen Volumina und Diameter und damit auch zu einer Reduktion der Mitralinsuffizienz führt [9][10][11][12][13]. Bei näherer Betrachtung der Überlebenskurven aus der COMPANION-Studie wird ersichtlich, dass sich der Vorteil der CRT-Gruppe gegenüber der medikamentös therapierten Gruppe erst nach ungefähr 8 Monaten herauskristallisiert.…”

Section: Days After Randomizationunclassified

Kardiale Resynchronisationstherapie (CRT): mit oder ohne ICD-back-Up?

2006

Schweiz Ärzteztg

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Cardiac Resynchronisation Therapy (CRT): with or without ICD back-up?The incidence of heart failure is increasing and patients are threatened to die of pump failure as well as of sudden cardiac death (SCD). Lately, cardiac resynchronisation therapy (CRT) has been introduced to treat patients with persistent heart failure and dyssynchronous left ventricular activation evidenced by complete left bundle branch block in the ECG. The COMPANION trial demonstrated, that in patients with an EF <0.35, NYHA class III or IV, and complete left bundle branch block, CRT with and without implantable cardioverter defibrillator (ICD) back-up reduced the combined endpoint of mortality and hospitalisation. A reduction in total mortality could only be achieved by the use of CRT-ICD. The CARE-HF trial randomised similar patients to CRT or medical treatment. The secondary endpoint of death from all causes was reached by significantly fewer patients in the CRT group. However, approximately one third of the deaths was attributable to SCD.To date, there is no trial available comparing the effects of CRT and CRT-ICD on total mortality as a primary endpoint. Apart from the results of the COMPANION trial, several conclusions can be drawn from primary prevention trials in the general ICD population. The SCD-HeFT trial showed a significant mortality reduction in patients with an LVEF 90.35 who received an ICD for primary prevention as compared to placebo and amiodarone. After successful treatment with CRT, the mean LVEF improved from 0.25 to 0.32 in the CARE-HF trial. The majority of patients would therefore continue to fulfil the criteria for ICD-implantation according to the SCDHeFT trial. SCD-HeFT also showed a mortality reduction in patients with NYHA class II but not in those with NYHA class III. It is conceivable, that CRT can change the mode of death from pump failure to SCD. To date, the available data indicate, that an ICD-back-up should at least be considered in every patient eligible for CRT therapy.

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Left ventricular function and visual phase analysis with equilibrium radionuclide angiography in patients with biventricular device

Muxí

Paredes

Mont

et al. 2008

Eur J Nucl Med Mol Imaging

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ERNA permits the study of resynchronisation patients, showing a statistical LVEF improvement at 6 months. Moreover, visual phase analysis permits the study of the mechanism involved in the response, with an important number of responders with no changes between the two modes at 6 months. In the 72-h study, after disconnection of the device, LVEF and resynchronisation worsening can predict patient improvement at 6 months.

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Marked Improvement in Left Ventricular Function and Significant Reverse Left Ventricular Remodeling within 3 Months of Cardiac Resynchronization Therapy in Patients with Dilated Cardiomyopathy

Cited by 6 publications

References 5 publications

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Kardiale Resynchronisationstherapie (CRT): mit oder ohne ICD-back-Up?

Left ventricular function and visual phase analysis with equilibrium radionuclide angiography in patients with biventricular device

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