PMID- 31543195
OWN - NLM
STAT- MEDLINE
DCOM- 20200225
LR  - 20200501
IS  - 2213-3763 (Electronic)
IS  - 0019-4832 (Print)
IS  - 0019-4832 (Linking)
VI  - 71
IP  - 3
DP  - 2019 May-Jun
TI  - Cardiac resynchronization therapy in patients with heart failure and moderately 
      reduced ejection fraction: Could it trigger a super-response?
PG  - 229-234
LID - S0019-4832(19)30036-7 [pii]
LID - 10.1016/j.ihj.2019.04.010 [doi]
AB  - BACKGROUND/AIM: Despite the well-established benefits of cardiac 
      resynchronization therapy (CRT) in heart failure (HF) patients with left 
      ventricular ejection fraction (LVEF) </=35%, many patients with less reduced EF 
      remain refractory to optimized medical treatment and at high risk of morbidity 
      and mortality. The objective of the study is to evaluate the effects of CRT in 
      optimally treated patients with New York Heart Association (NYHA) classes II-IV, 
      LVEF of 36-45%, and left bundle branch (LBBB), including clinical, structural and 
      biochemical response. METHODS: A selected group of HF patients have been 
      implanted with CRT-P devices and were followed up for 6 months at 4, 12 and 24 
      weeks. Clinical assessment included NYHA class, quality of life and 6-min walk 
      distance (6 MWD) test. Echocardiographic assessment included LV dimensions and 
      function and left atrial volume. Serum N-terminal pro b-type natriuretic peptide 
      (NT-ProBNP) was measured at the same intervals. RESULTS: This prospective single 
      center study included 23 patients. NYHA functional class significantly improved 
      after CRT-P (p < 0.0001), associated with improvement in QOL (p < 0.0001) and 6 
      MWD, which increased, from 145.7 +/- 20.1 m to 219.5 +/- 42.2 m (p < 0.0001). Mean 
      QRS duration showed significant shortening from 164.4 +/- 13.2 ms to 
      126.4 +/- 13.6 ms (p < 0.0001). CRT induced reverse remodeling with reduction in 
      both left ventricular end diastolic diameter (LVEDD) from 68.95 +/- 5.05 mm to 
      62.8 +/- 4.47 mm, p = 0.0002 and left ventricular end systolic diameter (LVESD) 
      from 54.1 +/- 4.5 mm to 46.5 +/- 4.1 mm, p < 0.0001, and significant increase in LVEF 
      (from 40.3 +/- 2.8 to 48.3 +/- 4.2 mm, p < 0.0001). The biochemical response to CRT 
      showed significant reduction in serum NT-ProBNP from 1025.6 +/- 363.1 pg/ml to 
      594.9 +/- 263.5 pg/ml (p < 0.0001). CONCLUSIONS: Symptomatic HF patients on maximal 
      optimized medical treatment who have LBBB and baseline LVEF 35-45% appeared to 
      derive significant clinical and structural benefit from CRT.
CI  - Copyright (c) 2019 Cardiological Society of India. Published by Elsevier B.V. All 
      rights reserved.
FAU - Tawfik Ghanem, Mazen
AU  - Tawfik Ghanem M
AD  - Cardiology Department, Ain Shams University, Egypt. Electronic address: 
      mazentawfik@gmail.com.
FAU - Allam, Lamyaa Elsayed
AU  - Allam LE
AD  - Cardiology Department, Ain Shams University, Egypt. Electronic address: 
      Lamallam.eps@gmail.com.
FAU - Samir Ahmed, Rania
AU  - Samir Ahmed R
AD  - Cardiology Department, Ain Shams University, Egypt. Electronic address: 
      Raniasamir_3@msn.com.
LA  - eng
PT  - Journal Article
DEP - 20190503
PL  - India
TA  - Indian Heart J
JT  - Indian heart journal
JID - 0374675
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Bundle-Branch Block/complications/physiopathology/*therapy
MH  - *Cardiac Resynchronization Therapy
MH  - Cardiac Resynchronization Therapy Devices
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/complications/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/physiopathology
PMC - PMC6796628
OTO - NOTNLM
OT  - CRT
OT  - Congestive heart failure
OT  - Left ventricular systolic function
OT  - Pacing
OT  - Quality of life
EDAT- 2019/09/24 06:00
MHDA- 2020/02/26 06:00
PMCR- 2020/05/01
CRDT- 2019/09/24 06:00
PHST- 2019/01/22 00:00 [received]
PHST- 2019/03/02 00:00 [revised]
PHST- 2019/04/26 00:00 [accepted]
PHST- 2019/09/24 06:00 [entrez]
PHST- 2019/09/24 06:00 [pubmed]
PHST- 2020/02/26 06:00 [medline]
PHST- 2020/05/01 00:00 [pmc-release]
AID - S0019-4832(19)30036-7 [pii]
AID - 10.1016/j.ihj.2019.04.010 [doi]
PST - ppublish
SO  - Indian Heart J. 2019 May-Jun;71(3):229-234. doi: 10.1016/j.ihj.2019.04.010. Epub 
      2019 May 3.