PMID- 20920655
OWN - NLM
STAT- MEDLINE
DCOM- 20101026
LR  - 20161125
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 106
IP  - 8
DP  - 2010 Oct 15
TI  - Effect of cardiac resynchronization therapy in patients with New York Heart 
      Association functional class IV heart failure.
PG  - 1146-51
LID - 10.1016/j.amjcard.2010.06.025 [doi]
AB  - Cardiac resynchronization therapy (CRT) is considered a class I indication in 
      treatment of patients with New York Heart Association (NYHA) functional class III 
      and IV heart failure. However, only small numbers of patients in large clinical 
      trials have been in NYHA functional class IV. Therefore, little is known about 
      the effects of CRT in this group. Therefore, we evaluated the effects of CRT in 
      patients with NYHA functional class IV heart failure. Of all patients referred 
      for CRT implantation, 61 patients with symptoms according to NYHA functional 
      class IV were included. All patients were evaluated before implantation and at 
      6-month follow-up for clinical changes according to the clinical composite score 
      and changes in left ventricular (LV) volumes and function. In addition, survival 
      was evaluated during long-term follow-up. At 6-month follow-up, 9 patients (15%) 
      had died and 2 patients (3%) were admitted for worsening heart failure. The 
      remaining 39 patients (64%) showed improvement according to the clinical 
      composite score. Decreases in LV end-systolic volume (from 167 +/- 88 to 147 +/- 93 
      ml, p = 0.009) and LV end-diastolic volume (from 211 +/- 100 to 199 +/- 113 ml, p = 
      0.135) were observed, as was a significant increase in LV ejection fraction (from 
      22 +/- 8% to 28 +/- 9%, p <0.001). During a mean follow-up of 30 +/- 26 months, 36 
      patients (59%) died, 27 (75%) from worsening heart failure. Respective 1- and 
      2-year mortality rates were 25% and 38%. In conclusion, CRT decreases LV volumes 
      and improves cardiac function in patients with NYHA functional class IV heart 
      failure. Nevertheless, (heart failure) mortality remains high in these patients.
CI  - Copyright (c) 2010 Elsevier Inc. All rights reserved.
FAU - van Bommel, Rutger J
AU  - van Bommel RJ
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - van Rijnsoever, Eva
AU  - van Rijnsoever E
FAU - Borleffs, C Jan Willem
AU  - Borleffs CJ
FAU - Delgado, Victoria
AU  - Delgado V
FAU - Marsan, Nina Ajmone
AU  - Marsan NA
FAU - Bertini, Matteo
AU  - Bertini M
FAU - Schalij, Martin J
AU  - Schalij MJ
FAU - Bax, Jeroen J
AU  - Bax JJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Cardiac Volume/*physiology
MH  - *Defibrillators, Implantable
MH  - Echocardiography
MH  - Electric Countershock/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/classification/physiopathology/*therapy
MH  - Heart Ventricles/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Myocardial Contraction/*physiology
MH  - Prognosis
MH  - Quality of Life
MH  - Severity of Illness Index
MH  - Surveys and Questionnaires
MH  - Time Factors
MH  - Ventricular Function, Left/*physiology
EDAT- 2010/10/06 06:00
MHDA- 2010/10/27 06:00
CRDT- 2010/10/06 06:00
PHST- 2010/03/10 00:00 [received]
PHST- 2010/06/02 00:00 [revised]
PHST- 2010/06/02 00:00 [accepted]
PHST- 2010/10/06 06:00 [entrez]
PHST- 2010/10/06 06:00 [pubmed]
PHST- 2010/10/27 06:00 [medline]
AID - S0002-9149(10)01212-9 [pii]
AID - 10.1016/j.amjcard.2010.06.025 [doi]
PST - ppublish
SO  - Am J Cardiol. 2010 Oct 15;106(8):1146-51. doi: 10.1016/j.amjcard.2010.06.025.