The magnitude of reverse remodelling irrespective of aetiology predicts outcome of heart failure patients treated with cardiac resynchronization therapy
Key result
A change in LVEF ≥6 points after cardiac resynchronization therapy significantly decreased the risk of mortality, urgent transplantation, or LVAD implantation (HR 0.30, P=0.001).
Why the study?
Does the magnitude of reverse remodelling (LVEF change) predict long-term outcomes in heart failure patients treated with CRT?
Population
398 consecutive heart failure patients who underwent cardiac resynchronization therapy between September…
Design
Cohort
Follow-up
median 4.4 years
Authors
Discussion
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Implication
Reverse remodelling after CRT may refine post-implant risk stratification; leaves open whether it is a modifiable target for survival.
Study Design
Type
Observational (n=398)
Structured PICO
Does the magnitude of reverse remodelling (LVEF change) predict long-term outcomes in heart failure patients treated with CRT?
P
Population
398 consecutive heart failure patients (179 non-ischaemic, 219 ischaemic) who underwent cardiac resynchronization therapy, followed for a median of 4.4 years.
E
Exposure
Cardiac resynchronization therapy (CRT)
O
Outcome
Composite of all-cause mortality, urgent transplantation, and implantation of left ventricular assist devicecomposite
Main Result
Hazard Ratio: 0.3
p-value: p=0.001
Reverse remodelling (LVEF increase ≥6 points) after 3-6 months of CRT is a strong predictor of long-term event-free survival, independent of heart failure aetiology.
Cite This Study
Biase et al. (2008) conducted an observational in Heart failure (n=398). Change in LVEF ≥6 points after CRT vs. Change in LVEF <6 points was evaluated on All-cause mortality, urgent transplantation, and implantation of left ventricular assist device (HR 0.30, p=0.001). A change in LVEF ≥6 points after cardiac resynchronization therapy significantly decreased the risk of mortality, urgent transplantation, or LVAD implantation (HR 0.30, P=0.001).