PMID- 16563976
OWN - NLM
STAT- MEDLINE
DCOM- 20060720
LR  - 20071115
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 25
IP  - 4
DP  - 2006 Apr
TI  - Cardiac resynchronization therapy delays heart transplantation in patients with 
      end-stage heart failure and mechanical dyssynchrony.
PG  - 447-53
AB  - BACKGROUND: Cardiac dyssynchrony is frequent in advanced heart failure, and 
      cardiac resynchronization therapy (CRT) may offer an alternative to heart 
      transplantation. We aimed to investigate the impact of CRT on freedom from Tx and 
      death in transplant candidates with end-stage heart failure. METHODS: Over a 
      period of 2 years, 46 consecutive patients with refractory congestive heart 
      failure due to dilated cardiomyopathy were referred for heart transplant 
      evaluation. Patients with cardiac dyssynchrony > 107 milliseconds according to 
      tissue Doppler imaging (TDI) or QRS duration > 150 milliseconds were treated with 
      CRT (CRT group, n = 24), whereas patients without dyssynchrony were not treated 
      (non-CRT group, n = 22). RESULTS: At baseline, both groups showed similar 
      hemodynamic and functional parameters, including ejection fraction (19 +/- 10% vs 
      21 +/- 12%, not statistically significant [NS]) and Vo2max (11.9 +/- 2.0 vs 12.0 
      +/- 1.8 ml/kg/min, NS). After a follow-up of 488 +/- 346 days, cumulative 
      survival with freedom from transplantation and death was higher in CRT vs non-CRT 
      patients (92% vs 39%; p < 0.001). CRT patients showed a decrease in New York 
      Heart Association (NYHA) class from 3.2 +/- 1.1 to 2.2 +/- 0.9 (p = 0.003) and an 
      increase in Vo2max from 11.9 +/- 2.0 to 13.1 +/- 1.8 ml/kg/min (p = 0.02), and 
      71% (17 of 24) of these patients were successfully removed from the waiting list. 
      CONCLUSIONS: In heart transplant candidates with significant dyssynchrony, CRT 
      delays heart transplantation and improves NYHA class and exercise capacity. For 
      these patients, CRT should be considered before heart transplantation.
FAU - Vanderheyden, Marc
AU  - Vanderheyden M
AD  - Cardiovascular Center, Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium. 
      marc.vanderheyden@olvz-aalst.be
FAU - Wellens, Francis
AU  - Wellens F
FAU - Bartunek, Jozef
AU  - Bartunek J
FAU - Verstreken, Sofie
AU  - Verstreken S
FAU - Walraevens, Maarten
AU  - Walraevens M
FAU - Geelen, Peter
AU  - Geelen P
FAU - De Proft, Margot
AU  - De Proft M
FAU - Goethals, Marc
AU  - Goethals M
LA  - eng
PT  - Journal Article
DEP - 20060228
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Aged
MH  - Arrhythmias, Cardiac/etiology/*therapy
MH  - Cardiomyopathy, Dilated/*complications
MH  - *Electric Countershock
MH  - Exercise Tolerance
MH  - Female
MH  - Heart Failure/etiology/*surgery
MH  - *Heart Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Preoperative Care
MH  - Time Factors
EDAT- 2006/03/28 09:00
MHDA- 2006/07/21 09:00
CRDT- 2006/03/28 09:00
PHST- 2005/05/09 00:00 [received]
PHST- 2005/08/20 00:00 [revised]
PHST- 2005/11/17 00:00 [accepted]
PHST- 2006/03/28 09:00 [pubmed]
PHST- 2006/07/21 09:00 [medline]
PHST- 2006/03/28 09:00 [entrez]
AID - S1053-2498(05)01346-X [pii]
AID - 10.1016/j.healun.2005.11.454 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2006 Apr;25(4):447-53. doi: 
      10.1016/j.healun.2005.11.454. Epub 2006 Feb 28.