PMID- 32790157
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 7
IP  - 5
DP  - 2020 Oct
TI  - Cardiac resynchronization therapy in New York Heart Association class-IV patients 
      dependent on intravenous drugs or invasive supportive treatments.
PG  - 3109-3118
LID - 10.1002/ehf2.12940 [doi]
AB  - AIMS: We sought to evaluate the effectiveness of cardiac resynchronization 
      therapy (CRT) in far-advanced heart failure (FA-HF) patients with New York Heart 
      Association (NYHA) class-IV status and dependency on intravenous drugs (IVDs) 
      and/or invasive supportive treatments (ISTs). METHODS AND RESULTS: Among 305 
      patients who underwent CRT implantation between October 2005 to December 2019, we 
      identified 17 FA-HF patients with NYHA class-IV status and dependency on IVDs 
      (inotropes, diuretics, vasopressors, or vasodilators) and/or ISTs (extracorporeal 
      membranous oxygenator or continuous renal replacement therapy). All patients 
      (median age = 68.7 years, non-ischaemic cardiomyopathy = 15) remained dependent 
      on several IVDs (2.2 +/- 1.3 per patient) and/or ISTs for 11.3 +/- 7.8 days due to 
      multiple tapering failure (4.3 +/- 3.2 per patient) before CRT implantation. 
      However, 14 (82%) patients were successfully weaned from IVDs/ISTs within 5.2 +/- 
      5.3 days following CRT, and 12 (71%) stayed alive for more than 1 year free of 
      ventricular assist device or heart transplantation with symptom improvement (>/=1 
      NYHA class) and a reduced annual HF hospitalization rate (P = 0.002). 
      Considerable improvements in ventricular systolic function (P = 0.004) and 
      volumetric reverse remodelling (P = 0.007) were noticed during the long-term 
      follow-up period (35 +/- 15 months post-CRT). The ventricular assist device/heart 
      transplantation/death-free survival rate post-CRT was 71% and 65% at 1 and 3 
      years, respectively. CONCLUSIONS: Cardiac resynchronization therapy implantation 
      may be a feasible treatment that can offer short-term and long-term clinical 
      benefits for NYHA class-IV FA-HF patients who are dependent on IVDs/ISTs. When 
      considering treatment options, CRT should not be prematurely excluded solely 
      based on a patient's dependency on IVDs/ISTs without first attempting to identify 
      favourable CRT response factors.
CI  - (c) 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Lee, Seong Soo
AU  - Lee SS
AD  - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, 
      Gangnam-gu, Seoul, 06351, Korea.
FAU - Kwon, Hee-Jin
AU  - Kwon HJ
AD  - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, 
      Gangnam-gu, Seoul, 06351, Korea.
FAU - Park, Kyoung-Min
AU  - Park KM
AD  - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, 
      Gangnam-gu, Seoul, 06351, Korea.
FAU - On, Young Keun
AU  - On YK
AD  - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, 
      Gangnam-gu, Seoul, 06351, Korea.
FAU - Kim, June Soo
AU  - Kim JS
AD  - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, 
      Gangnam-gu, Seoul, 06351, Korea.
FAU - Park, Seung-Jung
AU  - Park SJ
AD  - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, 
      Gangnam-gu, Seoul, 06351, Korea.
LA  - eng
PT  - Journal Article
DEP - 20200813
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
RN  - 0 (Pharmaceutical Preparations)
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - *Heart Failure/therapy
MH  - *Heart Transplantation
MH  - Humans
MH  - New York
MH  - *Pharmaceutical Preparations
PMC - PMC7524047
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Far-advanced heart failure
OT  - New York Heart Association class IV
OT  - Prognosis
COIS- None declared.
EDAT- 2020/08/14 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/08/13
CRDT- 2020/08/14 06:00
PHST- 2020/04/03 00:00 [received]
PHST- 2020/06/03 00:00 [revised]
PHST- 2020/07/19 00:00 [accepted]
PHST- 2020/08/14 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/08/14 06:00 [entrez]
PHST- 2020/08/13 00:00 [pmc-release]
AID - EHF212940 [pii]
AID - 10.1002/ehf2.12940 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2020 Oct;7(5):3109-3118. doi: 10.1002/ehf2.12940. Epub 2020 Aug 
      13.