PMID- 18507542
OWN - NLM
STAT- MEDLINE
DCOM- 20080627
LR  - 20220316
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 31
IP  - 6
DP  - 2008 Jun
TI  - Time course of effects of cardiac resynchronization therapy in chronic heart 
      failure: benefits in patients with preserved exercise capacity.
PG  - 701-8
LID - 10.1111/j.1540-8159.2008.01073.x [doi]
AB  - OBJECTIVES: To assess in patients with chronic heart failure the effect of 
      cardiac resynchronization therapy (CRT) over 12 months' follow-up the time course 
      of the changes in functional and neurohormonal indices and to identify responders 
      to CRT. METHODS: Eighty-nine patients (74.1 +/- 1 years, left ventricular 
      ejection fraction [LVEF] < 35%), QRS complex duration >150 ms, in stable New York 
      Heart Association (NYHA) class III or IV on optimal medical treatment were 
      prospectively randomized either in a control (n = 45) or CRT (n = 44) group and 
      underwent clinical evaluation, cardiopulmonary exercise testing (CPET), 2D-Echo, 
      heart rate variability (HRV), carotid baroreflex (BRS), and BNP assessments 
      before and at 6- and 12-month follow-up. RESULTS: In the CRT group, improvement 
      of cardiac indices and BNP concentration were evident at medium term (over 6 
      months) follow-up, and these changes persisted on a longer term (12 months) (all 
      P < 0.05). Instead CPET indices and NYHA class improved after 12 months 
      associated with restoration of HRV and BRS (all P < 0.05). We identified 26 
      responders to CRT according to changes in LVEF and diameters. Responders 
      presented less depressed hemodynamic (LVEF 25 +/- 1.0 vs 22 +/- 0.1%), functional 
      (peak VO(2) 10.2 +/- 0.2 vs 6.9 +/- 0.3 ml/kg/min), and neurohormonal indices 
      (HRV 203.6 +/- 15.7 vs 147.6 +/- 10.ms, BRS 4.9 +/- 0.2 vs 3.6 +/- 0.3 ms/mmHg) 
      (all P < 0.05). In the multivariate analysis, peak VO(2) was the strongest 
      predictor of responders. CONCLUSIONS: Improvement in functional status is 
      associated with restoration of neurohormonal reflex control at medium term. Less 
      depressed functional status (peak VO(2)) was the strongest predictor of 
      responders to CRT.
FAU - Piepoli, Massimo F
AU  - Piepoli MF
AD  - Heart Failure Unit, Cardiac Department, G. da Saliceto Polichirurgico Hospital, 
      Piacenza, Italy. m.piepoli@ausl.pc.it
FAU - Villani, Giovanni Q
AU  - Villani GQ
FAU - Corra, Ugo
AU  - Corra U
FAU - Aschieri, Daniela
AU  - Aschieri D
FAU - Rusticali, Guido
AU  - Rusticali G
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Chronic Disease
MH  - *Exercise Tolerance
MH  - Female
MH  - Heart Failure/*diagnosis/*prevention & control
MH  - Humans
MH  - Male
MH  - *Recovery of Function
MH  - Treatment Outcome
EDAT- 2008/05/30 09:00
MHDA- 2008/06/28 09:00
CRDT- 2008/05/30 09:00
PHST- 2008/05/30 09:00 [pubmed]
PHST- 2008/06/28 09:00 [medline]
PHST- 2008/05/30 09:00 [entrez]
AID - PACE1073 [pii]
AID - 10.1111/j.1540-8159.2008.01073.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2008 Jun;31(6):701-8. doi: 
      10.1111/j.1540-8159.2008.01073.x.