PMID- 31189165
OWN - NLM
STAT- MEDLINE
DCOM- 20191226
LR  - 20191226
IS  - 1421-9751 (Electronic)
IS  - 0008-6312 (Linking)
VI  - 142
IP  - 3
DP  - 2019
TI  - Long-Term Effect of Different Optimizing Methods for Cardiac Resynchronization 
      Therapy in Patients with Heart Failure: A Randomized and Controlled Pilot Study.
PG  - 158-166
LID - 10.1159/000499502 [doi]
AB  - AIM: During cardiac resynchronization therapy (CRT), optimized programming of the 
      atrioventricular (AV) delay and ventricular-to-ventricular (VV) interval can lead 
      to improved hemodynamics, symptomatic response, and left ventricular systolic 
      function. Currently, however, there is no recommendation for the best 
      optimization method. This study aimed to compare the long-term clinical outcomes 
      of 4 different CRT optimization methods. METHODS: One hundred and twenty-four 
      consecutive CRT patients with severe heart failure and left bundle-branch block 
      configuration were randomly assigned into four groups to undergo AV/VV delay 
      optimization through echocardiogram (ECHO; n = 30), electrocardiogram (ECG; n = 
      32), QuickOpt algorithm (n = 28), and nominal AV/VV (n = 36) groups. Patients 
      were followed up and underwent examinations, including New York Heart Association 
      (NYHA) cardiac functional classification, 6-min walking distance (6MWD), and 
      echocardiography, at 6, 12, 24, 36, and 48 months, respectively. The patients' 
      survival and clinical outcomes were compared among the four groups. RESULTS: 
      Kaplan-Meier survival analyses showed that the median survival was the same in 
      the 4 groups: ECHO, 43 months; ECG, 44 months; QuickOpt, 44 months, and nominal, 
      41 months. At the 6-month follow-up, the reduction in left ventricular end 
      diastolic diameter (LVEDD) was significantly less in the nominal group (-1.91 +/- 
      2.58 mm) than that in the other three groups (ECHO: -3.70 +/- 2.78 mm, p = 0.012; 
      ECG: -3.53 +/- 3.14 mm, p = 0.020; QuickOpt: -3.46 +/- 2.65 mm, p = 0.032); 6MWD was 
      significantly shorter in the nominal group (87.88 +/- 34.76 m) than that in the 
      other three groups (ECHO: 120.63 +/- 56.93 m, p = 0.006; ECG: 114.97 +/- 54.95 m, p = 
      0.020; QuickOpt: 114.57 +/- 35.41 m, p = 0.027). Left ventricular ejection fraction 
      (LVEF) significantly increased in ECHO (7.23 +/- 2.76%, p = 0.010), ECG (8.50 +/- 
      3.17%, p < 0.001), and QuickOpt (8.39 +/- 2.90%, p < 0.001) compared with the 
      nominal group (5.35 +/- 2.59%). There were no significant differences among the 
      groups in the aforementioned parameters at 24, 36, and 48 months, respectively. 
      CONCLUSION: While LVEDD, LVEF, 6MWD, and NYHA were significantly improved in 
      ECHO, ECG, and QuickOpt at 6 months, there were no significant improvements in 
      any of the groups at 12, 24, and 48 months. These findings suggested that the 
      long-term effect of the four CRT methods for heart failure was not significantly 
      different.
CI  - (c) 2019 S. Karger AG, Basel.
FAU - Zhang, Yu
AU  - Zhang Y
AD  - Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 
      Shanghai, China, lqlk57@163.com.
FAU - Xing, Qiang
AU  - Xing Q
AD  - Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, 
      Urumqi, China.
FAU - Zhang, Jiang-Hua
AU  - Zhang JH
AD  - Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, 
      Urumqi, China.
FAU - Jiang, Wei-Feng
AU  - Jiang WF
AD  - Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 
      Shanghai, China.
FAU - Qin, Mu
AU  - Qin M
AD  - Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 
      Shanghai, China.
FAU - Liu, Xu
AU  - Liu X
AD  - Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 
      Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20190612
PL  - Switzerland
TA  - Cardiology
JT  - Cardiology
JID - 1266406
SB  - IM
MH  - Aged
MH  - Algorithms
MH  - Cardiac Resynchronization Therapy/adverse effects/*methods
MH  - China
MH  - *Echocardiography
MH  - *Electrocardiography
MH  - Female
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - Walk Test
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Echocardiography
OT  - Heart failure
OT  - Outcome
EDAT- 2019/06/13 06:00
MHDA- 2019/12/27 06:00
CRDT- 2019/06/13 06:00
PHST- 2019/01/25 00:00 [received]
PHST- 2019/03/10 00:00 [accepted]
PHST- 2019/06/13 06:00 [pubmed]
PHST- 2019/12/27 06:00 [medline]
PHST- 2019/06/13 06:00 [entrez]
AID - 000499502 [pii]
AID - 10.1159/000499502 [doi]
PST - ppublish
SO  - Cardiology. 2019;142(3):158-166. doi: 10.1159/000499502. Epub 2019 Jun 12.