Prevention of Disease Progression by Cardiac Resynchronization Therapy in Patients With Asymptomatic or Mildly Symptomatic Left Ventricular Dysfunction

Daubert, Claude; Gold, Michael R.; Abraham, William T.; Ghio, Stefano; Hassager, Christian; Goode, Grahame K.; Szili-Török, Tamás; Linde, Cecilia

doi:10.1016/j.jacc.2009.08.011

Cited by 309 publications

(77 citation statements)

References 24 publications

(32 reference statements)

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“…24 Extrapolating these effects to the CRT population suggest that a greater benefit for ICD backup may be present in mild HF, as noted in the present analysis. It is noteworthy that although most patients in REVERSE received concomitant ICDs, the guidelines for primary preventive ICDs were not identical between the countries included in this trial, as a lower percentage of Europeans patients received a CRT-D. 13 In contrast, the use of HF medication, which also reduces the risk of sudden cardiac death, was excellent and nearly identical between geographic regions.…”

Section: Discussionmentioning

confidence: 93%

“…CRT has been shown to improve functional status, reduce HF hospitalizations, promote reverse remodeling, and decrease all-cause mortality. [1][2][3][4][5][6][7][8][9][10][11]13 These benefits were demonstrated in prospective randomized trials of both CRT-P and CRT-D devices, but no study has been powered to compare these devices directly. COMPANION randomized patients with severe HF to CRT-P, CRT-D, or optimal medical therapy.…”

Section: Discussionmentioning

confidence: 99%

“…9,12,13 Briefly, eligible patients had American College of Cardiology/American Heart Association Stage C, New York Heart Association (NYHA) class I (previously symptomatic, currently asymptomatic) or NYHA class II (mildly symptomatic) HF for ≥3 months before enrollment. Patients were required to be in sinus rhythm with QRS duration ≥120 ms, an ejection fraction ≤40%, and an LV end-diastolic dimension ≥55 mm measured by transthoracic echocardiography.…”

Section: Methodsmentioning

confidence: 99%

“…9,13 The overall distribution of the clinical composite score improved with CRT. Results of the device subgroups are shown in Figure 1; the distributions were similar for the patients programmed to CRT ON with both groups having >50% classified as improved and <20% worsened (P=0.89 comparing CRT-P and CRT-D).…”

Section: Clinical Outcomesmentioning

confidence: 99%

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Implantable Defibrillators Improve Survival in Patients With Mildly Symptomatic Heart Failure Receiving Cardiac Resynchronization Therapy

Gold

Daubert

Abraham

et al. 2013

Circ: Arrhythmia and Electrophysiology

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Background-Cardiac resynchronization therapy (CRT) decreases mortality, improves functional status, and induces reverse left ventricular remodeling in selected populations with heart failure. These benefits have been noted with both CRT-pacemakers as well as those devices with defibrillator backup (CRT-D). However, there are little data comparing mortality between these 2 device types. Methods and Results-REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) was a multicenter, randomized trial of CRT among patients with mild heart failure. Long-term annual follow-up for 5 years was preplanned. The present analysis was confined to the 419 patients who were randomized to active CRT group. CRTpacemakers or CRT-D devices were implanted based on national guidelines at the time of enrollment, with 74 patients receiving CRT pacemaker devices and the remaining 345 patients receiving CRT-D devices. After 12 months of CRT, changes in the clinical composite score, left ventricular end systolic volume index, 6-minute walk time, and quality of life indices were similar between CRT pacemaker and CRT-D patients. However, long-term follow-up showed lower morality in the CRT-D group. Specifically, multivariable analysis showed that CRT-D (hazard ratio, 0.35; P=0.003) was a strong independent predictor of survival. Female sex, longer unpaced QRS duration, and smaller baseline left ventricular end systolic volume index also were also associated with better survival. Conclusions-REVERSE demonstrated that the addition of implantable cardioverter-defibrillator therapy to CRT is associated with improved long-term survival compared with CRT pacing alone in mild heart failure. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique Identifier: NCT00271154.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Implantable Defibrillators Improve Survival in Patients With Mildly Symptomatic Heart Failure Receiving Cardiac Resynchronization Therapy

Gold

Daubert

Abraham

et al. 2013

Circ: Arrhythmia and Electrophysiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Do większości badań z CRT włączono pacjentów z LVEF < 35%, choć do badania RAFT [267] i MADIT-CRT [268,269] już z LVEF < 30%, podczas gdy do badania REVERSE [270][271][272] z LVEF < 40%, a do badania BLOCK-HF [274] nawet z LVEF < 50%. Relatywnie nieduża grupa pacjentów z LVEF 35-40% została włączona do badań klinicznych.…”

Section: Terapia Resynchronizująca Sercaunclassified