PMID- 19250090
OWN - NLM
STAT- MEDLINE
DCOM- 20090529
LR  - 20090302
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 32 Suppl 1
DP  - 2009 Mar
TI  - Cardiac resynchronization therapy in patients with mildly impaired left 
      ventricular function.
PG  - S186-9
LID - 10.1111/j.1540-8159.2008.02280.x [doi]
AB  - AIMS: We sought to determine the unknown effects of cardiac resynchronization 
      therapy (CRT) in patients with a left ventricular ejection fraction (LVEF) >35%. 
      Because of its technical limitations, echocardiography (Echo) may underestimate 
      LVEF, compared with cardiovascular magnetic resonance (CMR). METHODS: Of 157 
      patients undergoing CRT (New York Heart Association [NYHA] functional class III 
      or IV, QRS > or = 120 ms), all of whom had a preimplant Echo-LVEF < or =35%, 130 
      had a CMR-LVEF < or =35% (Group A, 19.7 +/- 7.0%[mean +/- standard deviation]) 
      and 27 had a CMR-LVEF >35% (Group B, 43.6 +/- 7.7%). All patients underwent a CMR 
      scan at baseline and a clinical evaluation, including a 6-minute walk test and a 
      quality of life questionnaire, at baseline and after CRT. RESULTS: Both groups 
      derived similar improvements in NYHA functional class (A =-1.3, B =-1.2, [mean]), 
      quality of life scores (A =-21.6, B =-33.0; all P < 0.0001 for changes from 
      baseline), and 6-minute walking distance (A = 64.5, B = 70.1 m; P < 0.001 and P < 
      0.0001, respectively). Symptomatic response rates (increase by > or =1 NYHA 
      classes or 25% 6-minute walking distance) were 79% in group A and 92% in group B. 
      Over a maximum follow-up period of 5.9 years for events, patients in group A were 
      at a higher risk of death from any cause, hospitalization for major 
      cardiovascular events (P = 0.0232), or cardiovascular death (P = 0.0411). There 
      were borderline differences in the risk of death from any cause (P = 0.0664) and 
      cardiovascular death or hospitalization for heart failure (P = 0.0526). 
      CONCLUSIONS: This observational study suggests that the benefits of CRT extend to 
      patients with a LVEF > 35%.
FAU - Foley, Paul W X
AU  - Foley PW
AD  - University of Birmingham, Department of Cardiology, Good Hope Hospital, Heart of 
      England NHS Trust, Sutton Coldfield, United Kingdom.
FAU - Stegemann, Berthold
AU  - Stegemann B
FAU - Smith, Russell E A
AU  - Smith RE
FAU - Sanderson, John E
AU  - Sanderson JE
FAU - Leyva, Francisco
AU  - Leyva F
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*mortality
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Netherlands/epidemiology
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - *Stroke Volume
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/diagnosis/*mortality/*prevention & control
EDAT- 2009/03/11 09:00
MHDA- 2009/05/30 09:00
CRDT- 2009/03/03 09:00
PHST- 2009/03/03 09:00 [entrez]
PHST- 2009/03/11 09:00 [pubmed]
PHST- 2009/05/30 09:00 [medline]
AID - PACE2280 [pii]
AID - 10.1111/j.1540-8159.2008.02280.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2009 Mar;32 Suppl 1:S186-9. doi: 
      10.1111/j.1540-8159.2008.02280.x.