PMID- 23038789
OWN - NLM
STAT- MEDLINE
DCOM- 20130411
LR  - 20130218
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 99
IP  - 5
DP  - 2013 Mar
TI  - Time from emerging heart failure symptoms to cardiac resynchronisation therapy: 
      impact on clinical response.
PG  - 314-9
LID - 10.1136/heartjnl-2012-302807 [doi]
AB  - OBJECTIVE: To investigate whether time from onset of heart failure signs and/or 
      symptoms (ie, progression to stage C/D heart failure) until implantation affects 
      reverse remodelling and clinical outcome after cardiac resynchronisation therapy 
      (CRT). DESIGN: Cohort study of consecutive CRT patients, implanted between 1 
      October 2008 and 30 April 2011. SETTING: Single tertiary care centre (Ziekenhuis 
      Oost-Limburg, Genk, Belgium). PATIENTS: Consecutive CRT patients (n=172; 71+/-9 
      years), stratified into tertiles according to the time since first heart failure 
      signs and/or symptoms at implantation. MAIN OUTCOME MEASURES: Change in left 
      ventricular dimensions, New York Heart Association (NYHA) functional class and 
      freedom from all-cause mortality or heart failure admission. RESULTS: Baseline 
      renal function was better in patients implanted earlier after emerging heart 
      failure symptoms (estimated glomerular filtration rate=73+/-20 vs 63+/-23 vs 58+/-26 
      ml/min/1.73 m(2) for tertiles, respectively). After 6 months, decreases in left 
      ventricular end-diastolic/systolic diameter and improvement in NYHA functional 
      class were similar among tertiles. Freedom from all-cause mortality or heart 
      failure admission was better in patients with early implantation (p value=0.042). 
      However, this was not the case in patients with preserved renal function (p 
      value=0.794). Death from progressive heart failure was significantly more 
      frequent in patients implanted later in their disease course. CONCLUSIONS: 
      Reverse left ventricular remodelling after CRT is not affected by the duration of 
      heart failure. However, clinical outcome is better in patients implanted earlier 
      in their disease course, which probably relates to better renal preservation.
FAU - Verbrugge, Frederik Hendrik
AU  - Verbrugge FH
AD  - Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, Genk 3600, 
      Belgium.
FAU - Dupont, Matthias
AU  - Dupont M
FAU - Vercammen, Jan
AU  - Vercammen J
FAU - Jacobs, Linda
AU  - Jacobs L
FAU - Verhaert, David
AU  - Verhaert D
FAU - Vandervoort, Pieter
AU  - Vandervoort P
FAU - Tang, W H Wilson
AU  - Tang WH
FAU - Mullens, Wilfried
AU  - Mullens W
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121004
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2013 Mar;99(5):293-4. PMID: 23349344
MH  - Aged
MH  - Belgium/epidemiology
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Heart Ventricles/*physiopathology
MH  - Humans
MH  - Male
MH  - *Recovery of Function
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Remodeling/*physiology
EDAT- 2012/10/06 06:00
MHDA- 2013/04/12 06:00
CRDT- 2012/10/06 06:00
PHST- 2012/10/06 06:00 [entrez]
PHST- 2012/10/06 06:00 [pubmed]
PHST- 2013/04/12 06:00 [medline]
AID - heartjnl-2012-302807 [pii]
AID - 10.1136/heartjnl-2012-302807 [doi]
PST - ppublish
SO  - Heart. 2013 Mar;99(5):314-9. doi: 10.1136/heartjnl-2012-302807. Epub 2012 Oct 4.