PMID- 17711439
OWN - NLM
STAT- MEDLINE
DCOM- 20071107
LR  - 20071115
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 18
IP  - 10
DP  - 2007 Sep
TI  - Response to cardiac resynchronization therapy predicts survival in heart failure: 
      a single-center experience.
PG  - 1015-9
AB  - OBJECTIVE: To determine whether survival after cardiac resynchronization therapy 
      (CRT) is related to improvement in clinical or echocardiographic parameters. 
      BACKGROUND: In clinical trials, CRT improved symptoms, left ventricular (LV) 
      structure, function, and survival. In clinical practice, response to CRT is 
      highly variable and whether survival benefit is confined to those patients who 
      experience improvement in clinical status or cardiac structure and function is 
      unclear. METHODS: This is a single-center study of patients receiving clinically 
      indicated CRT between January 2002 and December 2004. RESULTS: Of 309 patients 
      (age 68 +/- 11 years, 83% male) receiving CRT at our institution during the study 
      period, 174 returned for follow-up and 127 had repeat echocardiography. Baseline 
      clinical characteristics and survival were similar among those who did or did not 
      return for follow-up. In paired analyses, New York Heart Association (NYHA) class 
      (-0.56 +/- 0.07, p < 0.0001), ejection fraction (EF, 6.3 +/- 0.7%, P < 0.0001), 
      LV dimension (-2.7 +/- 0.6 mm, P < 0.0001), pulmonary artery systolic pressure 
      (PASP, -4.6 +/- 1.3 mm Hg, P = 0.0007), and MR severity grade (-0.20 +/- 0.05, P 
      = 0.0002) improved after CRT. Survival after CRT was associated with decrease in 
      NYHA class (risk ratio [RR]= 0.43, P = 0.0004), increase in EF (RR = 0.94, P = 
      0.02), and decrease in PASP (RR = 0.96, P = 0.03). Change in EF and NYHA class 
      were correlated (r = -0.46, P < 0.0001) and, adjusting for this covariance, 
      change in NYHA (P = 0.04) but not EF (P = 0.12) was associated with improved 
      survival. CONCLUSION: Patients who experience improved symptoms, ventricular 
      function, and/or hemodynamics have better survival after CRT. These data enhance 
      understanding of the relationship between CRT clinical response and survival 
      benefit in clinical practice.
FAU - Cha, Yong-Mei
AU  - Cha YM
AD  - Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College 
      of Medicine, Rochester, Minnesota 55905, USA. cha.yongmei@mayo.edu
FAU - Rea, Robert F
AU  - Rea RF
FAU - Wang, Ming
AU  - Wang M
FAU - Shen, Win-Kuang
AU  - Shen WK
FAU - Asirvatham, Samuel J
AU  - Asirvatham SJ
FAU - Friedman, Paul A
AU  - Friedman PA
FAU - Munger, Thomas M
AU  - Munger TM
FAU - Espinosa, Raul E
AU  - Espinosa RE
FAU - Hodge, David O
AU  - Hodge DO
FAU - Hayes, David L
AU  - Hayes DL
FAU - Redfield, Margaret M
AU  - Redfield MM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20070816
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
CIN - J Cardiovasc Electrophysiol. 2007 Sep;18(10):1020-1. PMID: 17877465
MH  - Aged
MH  - Cardiac Pacing, Artificial/*mortality/trends
MH  - Echocardiography/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2007/08/23 09:00
MHDA- 2007/11/08 09:00
CRDT- 2007/08/23 09:00
PHST- 2007/08/23 09:00 [pubmed]
PHST- 2007/11/08 09:00 [medline]
PHST- 2007/08/23 09:00 [entrez]
AID - JCE926 [pii]
AID - 10.1111/j.1540-8167.2007.00926.x [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2007 Sep;18(10):1015-9. doi: 
      10.1111/j.1540-8167.2007.00926.x. Epub 2007 Aug 16.