PMID- 17897122
OWN - NLM
STAT- MEDLINE
DCOM- 20080214
LR  - 20201216
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 30
IP  - 10
DP  - 2007 Oct
TI  - Effect of posterolateral left ventricular scar on mortality and morbidity 
      following cardiac resynchronization therapy.
PG  - 1201-9
AB  - OBJECTIVES: To determine the effect of a posterolateral (PL) left ventricular 
      scar on mortality and morbidity following cardiac resynchronization therapy 
      (CRT). METHODS: Sixty-two patients with heart failure (age 67.3 +/- 9.6 yrs [mean 
      +/- SD], 45 males, New York Heart Association class [NYHA] class III or IV, left 
      ventricular ejection fraction [LVEF]= 35%, left bundle branch block, QRS > or = 
      120 ms) underwent late gadolinium enhancement cardiovascular magnetic resonance 
      (LGE-CMR) for scar imaging. Patients were followed up for 741 (75-1602) days 
      (mean [range]). RESULTS: The presence of a PL scar emerged as an independent 
      predictor of the composite endpoint of cardiovascular death or hospitalization 
      for worsening heart failure (HR: 3.06 [1.63, 7.7, P < 0.0001]) as well as the 
      endpoint of cardiovascular death (HR: 2.63 [1.39, 6.65], P = 0.0016). A 
      transmural PL scar was the strongest predictor of these endpoints (both P < 
      0.0001). The symptomatic responder rate (improvement by > or =1 NYHA classes or > 
      or =25% in 6-min walking distance) was 83% in the group with non-PL scars, but 
      only 47% in the group with transmural PL scars (P < 0.0001). Pacing over the scar 
      was associated with a higher mortality and morbidity than pacing outside the scar 
      (all P < 0.05). CONCLUSIONS: A PL scar is associated with a worse clinical 
      outcome following CRT, particularly if it is transmural. Pacing scarred left 
      ventricular myocardium carries a greater risk of mortality and morbidity than 
      pacing nonscarred myocardium.
FAU - Chalil, S
AU  - Chalil S
AD  - Department of Cardiology, University of Birmingham, Good Hope Hospital, Sutton 
      Coldfield, West Midlands, UK.
FAU - Stegemann, B
AU  - Stegemann B
FAU - Muhyaldeen, S A
AU  - Muhyaldeen SA
FAU - Khadjooi, K
AU  - Khadjooi K
FAU - Foley, P W
AU  - Foley PW
FAU - Smith, R E A
AU  - Smith RE
FAU - Leyva, F
AU  - Leyva F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Bundle-Branch Block/pathology
MH  - Cardiac Pacing, Artificial/*adverse effects/*mortality
MH  - Cicatrix/pathology
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/complications
MH  - Heart Ventricles/*pathology
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Pacemaker, Artificial
MH  - Stroke Volume
EDAT- 2007/09/28 09:00
MHDA- 2008/02/15 09:00
CRDT- 2007/09/28 09:00
PHST- 2007/09/28 09:00 [pubmed]
PHST- 2008/02/15 09:00 [medline]
PHST- 2007/09/28 09:00 [entrez]
AID - PACE841 [pii]
AID - 10.1111/j.1540-8159.2007.00841.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2007 Oct;30(10):1201-9. doi: 
      10.1111/j.1540-8159.2007.00841.x.