PMID- 17984215
OWN - NLM
STAT- MEDLINE
DCOM- 20080428
LR  - 20080215
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 94
IP  - 3
DP  - 2008 Mar
TI  - Long-term effect of cardiac resynchronisation in patients reporting mild symptoms 
      of heart failure: a report from the CARE-HF study.
PG  - 278-83
AB  - BACKGROUND: Cardiac resynchronisation therapy (CRT) improves symptoms and 
      prognosis in patients with heart failure and cardiac dyssynchrony. Guidelines 
      from the National Institute of Health and Clinical Excellence in the United 
      Kingdom recommend CRT for patients with recent or persistent moderate or severe 
      symptoms of heart failure. This analysis investigated whether the severity of 
      symptoms was an important determinant of the prognostic benefits of CRT. METHODS: 
      In CARE-HF, patients with left ventricular ejection fraction < or =35% and 
      markers of cardiac dyssynchrony who were, in the investigators' opinion, in New 
      York Heart Association (NYHA) class III/IV were randomly assigned to 
      pharmacological treatment alone or with addition of CRT. This analysis 
      investigated whether the severity of symptoms reported by patients, using Likert 
      Scales from the EuroHeart Failure Questionnaire and self-assessed NYHA class, 
      influenced prognosis and the response to CRT. RESULTS: Of 813 patients, 175 
      (21.5%) assessed themselves to be in NYHA class I or II. These patients also 
      reported less severe symptoms and better quality of life than patients who 
      assessed themselves to be in NYHA class III or IV. No statistical interaction was 
      observed between the severity of symptoms assessed in several ways and the 
      benefits of CRT on morbidity and mortality. CONCLUSIONS: The severity of symptoms 
      was not an important determinant of the prognostic effects of CRT in patients 
      with moderate or severe LVSD and markers of dyssynchrony in the CARE-HF study. 
      This finding requires confirmation in an adequately powered prospective 
      randomised controlled trial in patients with milder symptoms.
FAU - Cleland, J G F
AU  - Cleland JG
AD  - Department of Cardiology, University of Hull, Castle Hill Hospital, 
      Kingston-upon-Hull, UK. g.m.porter@hull.ac.uk
FAU - Freemantle, N
AU  - Freemantle N
FAU - Daubert, J-C
AU  - Daubert JC
FAU - Toff, W D
AU  - Toff WD
FAU - Leisch, F
AU  - Leisch F
FAU - Tavazzi, L
AU  - Tavazzi L
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20071105
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Epidemiologic Methods
MH  - Female
MH  - Heart Failure/mortality/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2007/11/07 09:00
MHDA- 2008/04/29 09:00
CRDT- 2007/11/07 09:00
PHST- 2007/11/07 09:00 [pubmed]
PHST- 2008/04/29 09:00 [medline]
PHST- 2007/11/07 09:00 [entrez]
AID - hrt.2007.128991 [pii]
AID - 10.1136/hrt.2007.128991 [doi]
PST - ppublish
SO  - Heart. 2008 Mar;94(3):278-83. doi: 10.1136/hrt.2007.128991. Epub 2007 Nov 5.