Cardiac resynchronization induces major structural and functional reverse remodeling in patients with New York heart association class I/II heart failure

Martin St. John Sutton, Stefano Ghio, Ted Plappert, Luigi Tavazzi, Laura Scelsi, Claude Daubert, William T. Abraham, Michael R. Gold, Christian Hassager, John M. Herre, Cecilia Linde

Research output: Contribution to journalArticlepeer-review

Abstract

Background-: Cardiac resynchronization therapy (CRT) improves LV structure, function, and clinical outcomes in New York Heart Association class III/IV heart failure with prolonged QRS. It is not known whether patients with New York Heart Association class I/II systolic heart failure exhibit left ventricular (LV) reverse remodeling with CRT or whether reverse remodeling is modified by the cause of heart failure. Methods and Results-: Six hundred ten patients with New York Heart Association class I/II heart failure, QRS duration ≥120 ms, LV end-diastolic dimension ≥55 mm, and LV ejection fraction ≤40% were randomized to active therapy (CRT on; n=419) or control (CRT off; n=191) for 12 months. Doppler echocardiograms were recorded at baseline, before hospital discharge, and at 6 and 12 months. When CRT was turned on initially, immediate changes occurred in LV volumes and ejection fraction; however, these changes did not correlate with the long-term changes (12 months) in LV end-systolic (r=0.11, P=0.31) or end-diastolic (r=0.10, P=0.38) volume indexes or LV ejection fraction (r=0.07, P=0.72). LV end-diastolic and end-systolic volume indexes decreased in patients with CRT turned on (both P

Original languageEnglish
Pages (from-to)1858-1865
Number of pages8
JournalCirculation
Volume120
Issue number19
DOIs
Publication statusPublished - Nov 2009

Keywords

  • Cardiac resynchronization therapy
  • Doppler echocardiography
  • Echocardiography
  • Heart failure
  • Ventricular remodeling

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

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