PMID- 25491007
OWN - NLM
STAT- MEDLINE
DCOM- 20150224
LR  - 20141210
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 115
IP  - 1
DP  - 2015 Jan 1
TI  - Long-term outcomes in patients with ambulatory new york heart association class 
      III and IV heart failure undergoing cardiac resynchronization therapy.
PG  - 82-5
LID - S0002-9149(14)01936-5 [pii]
LID - 10.1016/j.amjcard.2014.09.052 [doi]
AB  - Patients with ambulatory New York Heart Association (NYHA) class IV heart failure 
      were significantly underrepresented in clinical trials of cardiac 
      resynchronization therapy (CRT). The natural long-term trajectory of survival 
      free of left ventricular assist device (LVAD) or heart transplant in patients 
      with ambulatory class IV symptoms who underwent CRT has not been established. We 
      extracted clinical data on 723 consecutive patients with NYHA class III or 
      ambulatory class IV heart failure, left ventricular ejection fraction </=35%, and a 
      QRS duration >/=120 ms who underwent CRT from September 30, 2003, to August 6, 
      2007. Chart notes immediately before CRT were reviewed to confirm NYHA class 
      status before CRT. Kaplan-Meier curves and a multivariate Cox proportional 
      hazards model were constructed to determine long-term survival free of heart 
      transplant and LVAD based on NYHA class status. Of the 723 patients, 52 had 
      ambulatory class IV symptoms. Over a mean follow-up of 5.0 +/- 2.5 years 
      controlling for many possible confounders, ambulatory NYHA class IV status was 
      independently associated with poor long-term outcomes. The 1-, 2-, 3-, 4-, and 
      5-year survival free of LVAD or heart transplant for class III versus ambulatory 
      class IV patients was 92.0%, 84.0%, 75.0%, 68.1%, and 63.2% versus 75.0%, 61.5%, 
      52.0%, 45%, and 40.4%, respectively. Although patients with ambulatory class IV 
      heart failure receiving CRT have inferior long-term outcomes compared with those 
      with class III symptoms, survival in class IV patients continues to parallel 
      class III patients over an extended follow-up. At 5 years, survival free of LVAD 
      or heart transplant in ambulatory class IV patients receiving CRT is 40%.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Rickard, John
AU  - Rickard J
AD  - Division of Electrophysiology, Department of Cardiology, Johns Hopkins School of 
      Medicine, Baltimore, Maryland. Electronic address: jrickar5@jhmi.edu.
FAU - Bassiouny, Mohammed
AU  - Bassiouny M
AD  - Division of Cardiology, Heart and Vascular Institute, Cleveland Clinic, 
      Cleveland, Ohio.
FAU - Tedford, Ryan J
AU  - Tedford RJ
AD  - Division of Heart Failure Baltimore, Department of Cardiology, Johns Hopkins 
      School of Medicine, Baltimore, Maryland.
FAU - Baranowski, Bryan
AU  - Baranowski B
AD  - Division of Cardiology, Heart and Vascular Institute, Cleveland Clinic, 
      Cleveland, Ohio.
FAU - Spragg, David
AU  - Spragg D
AD  - Division of Electrophysiology, Department of Cardiology, Johns Hopkins School of 
      Medicine, Baltimore, Maryland.
FAU - Cantillon, Daniel
AU  - Cantillon D
AD  - Division of Cardiology, Heart and Vascular Institute, Cleveland Clinic, 
      Cleveland, Ohio.
FAU - Varma, Niraj
AU  - Varma N
AD  - Division of Cardiology, Heart and Vascular Institute, Cleveland Clinic, 
      Cleveland, Ohio.
FAU - Wilkoff, Bruce L
AU  - Wilkoff BL
AD  - Division of Cardiology, Heart and Vascular Institute, Cleveland Clinic, 
      Cleveland, Ohio.
FAU - Tang, W H Wilson
AU  - Tang WH
AD  - Division of Cardiology, Heart and Vascular Institute, Cleveland Clinic, 
      Cleveland, Ohio.
LA  - eng
GR  - R01HL103931/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20141015
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Ambulatory Care/*methods
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/classification/mortality/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ohio/epidemiology
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*physiology
EDAT- 2014/12/11 06:00
MHDA- 2015/02/25 06:00
CRDT- 2014/12/11 06:00
PHST- 2014/07/14 00:00 [received]
PHST- 2014/09/30 00:00 [revised]
PHST- 2014/09/30 00:00 [accepted]
PHST- 2014/12/11 06:00 [entrez]
PHST- 2014/12/11 06:00 [pubmed]
PHST- 2015/02/25 06:00 [medline]
AID - S0002-9149(14)01936-5 [pii]
AID - 10.1016/j.amjcard.2014.09.052 [doi]
PST - ppublish
SO  - Am J Cardiol. 2015 Jan 1;115(1):82-5. doi: 10.1016/j.amjcard.2014.09.052. Epub 
      2014 Oct 15.