PMID- 19038680
OWN - NLM
STAT- MEDLINE
DCOM- 20090106
LR  - 20220321
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 52
IP  - 23
DP  - 2008 Dec 2
TI  - Randomized trial of cardiac resynchronization in mildly symptomatic heart failure 
      patients and in asymptomatic patients with left ventricular dysfunction and 
      previous heart failure symptoms.
PG  - 1834-1843
LID - S0735-1097(08)02913-6 [pii]
LID - 10.1016/j.jacc.2008.08.027 [doi]
AB  - OBJECTIVES: We sought to determine the effects of cardiac resynchronization 
      therapy (CRT) in New York Heart Association (NYHA) functional class II heart 
      failure (HF) and NYHA functional class I (American College of Cardiology/American 
      Heart Association stage C) patients with previous HF symptoms. BACKGROUND: 
      Cardiac resynchronization therapy improves left ventricular (LV) structure and 
      function and clinical outcomes in NYHA functional class III and IV HF with 
      prolonged QRS. METHODS: Six hundred ten patients with NYHA functional class I or 
      II heart failure with a QRS > or =120 ms and a LV ejection fraction < or =40% 
      received a CRT device (+/-defibrillator) and were randomly assigned to active CRT 
      (CRT-ON; n = 419) or control (CRT-OFF; n = 191) for 12 months. The primary end 
      point was the HF clinical composite response, which scores patients as improved, 
      unchanged, or worsened. The prospectively powered secondary end point was LV 
      end-systolic volume index. Hospitalization for worsening HF was evaluated in a 
      prospective secondary analysis of health care use. RESULTS: The HF clinical 
      composite response end point, which compared only the percent worsened, indicated 
      16% worsened in CRT-ON compared with 21% in CRT-OFF (p = 0.10). Patients assigned 
      to CRT-ON experienced a greater improvement in LV end-systolic volume index 
      (-18.4 +/- 29.5 ml/m2 vs. -1.3 +/- 23.4 ml/m2, p < 0.0001) and other measures of 
      LV remodeling. Time-to-first HF hospitalization was significantly delayed in 
      CRT-ON (hazard ratio: 0.47, p = 0.03). CONCLUSIONS: The REVERSE 
      (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) 
      trial demonstrates that CRT, in combination with optimal medical therapy 
      (+/-defibrillator), reduces the risk for heart failure hospitalization and 
      improves ventricular structure and function in NYHA functional class II and NYHA 
      functional class I (American College of Cardiology/American Heart Association 
      stage C) patients with previous HF symptoms. (REsynchronization reVErses 
      Remodeling in Systolic Left vEntricular Dysfunction [REVERSE]; NCT00271154).
FAU - Linde, Cecilia
AU  - Linde C
AD  - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. 
      Electronic address: cecilia.linde@ki.se.
FAU - Abraham, William T
AU  - Abraham WT
AD  - Division of Cardiovascular Medicine and the Davis Heart and Lung Research 
      Institute, Ohio State University, Columbus, Ohio.
FAU - Gold, Michael R
AU  - Gold MR
AD  - Division of Cardiology, Medical University of South Carolina, Charleston, South 
      Carolina.
FAU - St John Sutton, Martin
AU  - St John Sutton M
AD  - University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
FAU - Ghio, Stefano
AU  - Ghio S
AD  - Policlinico San Matteo, Pavia, Italy.
FAU - Daubert, Claude
AU  - Daubert C
AD  - Departement de Cardiologie, CHU, Rennes, France.
CN  - REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular 
      dysfunction) Study Group
LA  - eng
SI  - ClinicalTrials.gov/NCT00271154
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20081107
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2008 Dec 2;52(23):1844-6. PMID: 19038681
CIN - J Am Coll Cardiol. 2009 Jun 9;53(23):2198; author reply 2198-9. PMID: 19497450
CIN - J Am Coll Cardiol. 2010 Jan 19;55(3):257-8. PMID: 20117407
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - Female
MH  - Heart/physiology
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Risk
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*therapy
MH  - Ventricular Remodeling
EDAT- 2008/11/29 09:00
MHDA- 2009/01/07 09:00
CRDT- 2008/11/29 09:00
PHST- 2008/06/13 00:00 [received]
PHST- 2008/07/31 00:00 [revised]
PHST- 2008/08/14 00:00 [accepted]
PHST- 2008/11/29 09:00 [pubmed]
PHST- 2009/01/07 09:00 [medline]
PHST- 2008/11/29 09:00 [entrez]
AID - S0735-1097(08)02913-6 [pii]
AID - 10.1016/j.jacc.2008.08.027 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2008 Dec 2;52(23):1834-1843. doi: 10.1016/j.jacc.2008.08.027. 
      Epub 2008 Nov 7.