PMID- 26802014
OWN - NLM
STAT- MEDLINE
DCOM- 20170803
LR  - 20170817
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 18
IP  - 5
DP  - 2016 May
TI  - The clinical outcome of cardiac resynchronization therapy in post-surgical 
      valvular cardiomyopathy.
PG  - 732-8
LID - 10.1093/europace/euv287 [doi]
AB  - AIMS: Trials have shown that cardiac resynchronization therapy (CRT) is effective 
      in patients with 'non-ischaemic cardiomyopathy'. Patients with post-surgical 
      valvular cardiomyopathy (PSVCM) have been excluded from such trials. We sought to 
      compare the clinical outcome of CRT in patients with PSVCM, idiopathic dilated 
      cardiomyopathy (IDCM), or ischaemic cardiomyopathy (ICM). METHODS AND RESULTS: 
      Clinical events and response to CRT were quantified in 556 patients (PSVCM = 38; 
      IDCM = 165; ICM = 353) over 4.52 years [median, inter-quartile range (IQR): 
      4.42]. Response to CRT was defined as survival for >/=1 year free of 
      hospitalizations plus improvement by >/=1 NYHA class or >/=25% in 6-min walking 
      distance. Cardiac resynchronization therapy was initiated at 5.86 years (median, 
      IQR: 9.86) after aortic valve replacement (73.7%) or mitral valve 
      replacement/repair (44.7%). Compared with PSVCM, IDCM was associated with a lower 
      total mortality [hazards ratio, HR: 0.54 (95% confidence interval, CI 
      0.34-0.84)], cardiac mortality [HR: 0.43 (95% CI 0.26-0.70)], and total mortality 
      or major adverse cardiovascular events [HR: 0.57 (95% CI 0.37-0.87)], independent 
      of known confounders. Compared with PSVCM, ICM was associated with a similar risk 
      of death from pump failure [HR: 0.83 (95% CI 0.50-1.37)] and IDCM was associated 
      with a lower risk [HR: 0.46 (95% CI 0.26-0.82)]. Response to CRT was similar 
      across the groups. CONCLUSIONS: Compared with IDCM, PSVCM was associated with a 
      worse outcome after CRT. Outcomes from PSVCM were similar to ICM. These findings 
      indicate that PSVCM behaves very differently to IDCM after CRT.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2016. For permissions please email: journals.permissions@oup.com.
FAU - Leyva, Francisco
AU  - Leyva F
AD  - Aston Medical Research Institute, Aston Medical School, Aston Triangle, 
      Birmingham, West Midlands B4 7ET, UK f.leyva@aston.ac.uk.
FAU - Umar, Fraz
AU  - Umar F
AD  - Centre for Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
FAU - Taylor, Robin J
AU  - Taylor RJ
AD  - Centre for Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
FAU - Steeds, Richard P
AU  - Steeds RP
AD  - Centre for Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
FAU - Frenneaux, Michael P
AU  - Frenneaux MP
AD  - Norwich Medical School, University of East Anglia, Norwich, UK.
LA  - eng
PT  - Journal Article
DEP - 20160122
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/surgery
MH  - *Cardiac Resynchronization Therapy/adverse effects
MH  - Cardiac Surgical Procedures
MH  - Cardiomyopathies/classification/*mortality/*therapy
MH  - Defibrillators, Implantable/*adverse effects
MH  - Echocardiography
MH  - Equipment Failure/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnostic imaging/*therapy
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/surgery
MH  - Multivariate Analysis
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - Time Factors
MH  - Time-to-Treatment
MH  - United Kingdom
OTO - NOTNLM
OT  - Aortic valve replacement
OT  - Cardiac resynchronization therapy
OT  - Mitral valve replacement
OT  - Prognosis
OT  - Valvular cardiomyopathy
EDAT- 2016/01/24 06:00
MHDA- 2017/08/05 06:00
CRDT- 2016/01/24 06:00
PHST- 2015/05/16 00:00 [received]
PHST- 2015/07/30 00:00 [accepted]
PHST- 2016/01/24 06:00 [entrez]
PHST- 2016/01/24 06:00 [pubmed]
PHST- 2017/08/05 06:00 [medline]
AID - euv287 [pii]
AID - 10.1093/europace/euv287 [doi]
PST - ppublish
SO  - Europace. 2016 May;18(5):732-8. doi: 10.1093/europace/euv287. Epub 2016 Jan 22.