Effects of cardiac resynchronization therapy on left ventricular mass and wall thickness in mild heart failure patients in MADIT-CRT
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Effects of cardiac resynchronization therapy on left ventricular mass and wall thickness in mild heart failure patients in MADIT-CRT. / Kutyifa, Valentina; Solomon, Scott D; Bourgoun, Mikhail; Shah, Amil M; Pouleur, Anne-Catherine; Knappe, Dorit; McNitt, Scott; Wang, Paul J; Merkely, Bela; Pfeffer, Marc; Moss, Arthur J; Zareba, Wojciech.
in: HEART RHYTHM, Jahrgang 10, Nr. 3, 03.2013, S. 354-360.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Effects of cardiac resynchronization therapy on left ventricular mass and wall thickness in mild heart failure patients in MADIT-CRT
AU - Kutyifa, Valentina
AU - Solomon, Scott D
AU - Bourgoun, Mikhail
AU - Shah, Amil M
AU - Pouleur, Anne-Catherine
AU - Knappe, Dorit
AU - McNitt, Scott
AU - Wang, Paul J
AU - Merkely, Bela
AU - Pfeffer, Marc
AU - Moss, Arthur J
AU - Zareba, Wojciech
N1 - Published by Elsevier Inc.
PY - 2013/3
Y1 - 2013/3
N2 - BACKGROUND: The effect of cardiac resynchronization therapy (CRT) on left ventricular wall thickness and left ventricular mass (LVM) is unknown.OBJECTIVES: To evaluate the effects of CRT on septal and posterior wall thickness (SWT and PWT) and LVM in patients with left bundle branch block (LBBB) and non-LBBB vs implantable cardioverter-defibrillator patients and to assess the relationship between CRT-induced changes and cardiac events.METHODS: We investigated 843 patients with LBBB and 366 patients with non-LBBB enrolled in the Multicenter Automatic Defibrillator Implantation Trial - Cardiac Resynchronization Therapy (MADIT-CRT) trial to analyze changes in SWT, PWT, and LVM at 12 months and subsequent outcome. The primary end point was heart failure or death; secondary end points included ventricular tachycardia, ventricular fibrillation, or death.RESULTS: In LBBB patients, reduction in SWT, PWT, and LVM was more pronounced in CRT defibrillator (CRT-D) than in implantable cardioverter-defibrillator (SWT:-6.7% ± 4.4% vs-1.0% ± 1.9%; PWT:-6.4% ± 4.3% vs-0.8% ± 1.9%; LVM:-23.6% ± 9.9% vs-5.1% ± 5.1%; P<.001 for all). In CRT-D patients with non-LBBB, LVM reduction was less pronounced; however, changes in SWT and PWT were comparable. Changes in LVM correlated with changes in left ventricular end-diastolic volume. In CRT-D patients with LBBB, reduction in SWT and LVM was associated with reduction in heart failure/death (SWT: hazard ratio 0.94; 95% confidence interval 0.89-0.99 per percent change; P = .03) and ventricular tachycardia/ventricular fibrillation/death (SWT: hazard ratio 0.95; 95% confidence interval 0.91-1.00; P = .04). CRT-D patients with non-LBBB did not show favorable reduction in clinical or arrhythmic end points related to changes in SWT, PWT, or LVM.CONCLUSIONS: CRT-D was associated with significant reduction in SWT, PWT, and LVM in patients with LBBB along with left ventricular volume changes and associated favorable clinical and arrhythmia outcomes.
AB - BACKGROUND: The effect of cardiac resynchronization therapy (CRT) on left ventricular wall thickness and left ventricular mass (LVM) is unknown.OBJECTIVES: To evaluate the effects of CRT on septal and posterior wall thickness (SWT and PWT) and LVM in patients with left bundle branch block (LBBB) and non-LBBB vs implantable cardioverter-defibrillator patients and to assess the relationship between CRT-induced changes and cardiac events.METHODS: We investigated 843 patients with LBBB and 366 patients with non-LBBB enrolled in the Multicenter Automatic Defibrillator Implantation Trial - Cardiac Resynchronization Therapy (MADIT-CRT) trial to analyze changes in SWT, PWT, and LVM at 12 months and subsequent outcome. The primary end point was heart failure or death; secondary end points included ventricular tachycardia, ventricular fibrillation, or death.RESULTS: In LBBB patients, reduction in SWT, PWT, and LVM was more pronounced in CRT defibrillator (CRT-D) than in implantable cardioverter-defibrillator (SWT:-6.7% ± 4.4% vs-1.0% ± 1.9%; PWT:-6.4% ± 4.3% vs-0.8% ± 1.9%; LVM:-23.6% ± 9.9% vs-5.1% ± 5.1%; P<.001 for all). In CRT-D patients with non-LBBB, LVM reduction was less pronounced; however, changes in SWT and PWT were comparable. Changes in LVM correlated with changes in left ventricular end-diastolic volume. In CRT-D patients with LBBB, reduction in SWT and LVM was associated with reduction in heart failure/death (SWT: hazard ratio 0.94; 95% confidence interval 0.89-0.99 per percent change; P = .03) and ventricular tachycardia/ventricular fibrillation/death (SWT: hazard ratio 0.95; 95% confidence interval 0.91-1.00; P = .04). CRT-D patients with non-LBBB did not show favorable reduction in clinical or arrhythmic end points related to changes in SWT, PWT, or LVM.CONCLUSIONS: CRT-D was associated with significant reduction in SWT, PWT, and LVM in patients with LBBB along with left ventricular volume changes and associated favorable clinical and arrhythmia outcomes.
KW - Cardiac Resynchronization Therapy/methods
KW - Cardiac Volume
KW - Electrocardiography
KW - Female
KW - Follow-Up Studies
KW - Heart Failure/diagnostic imaging
KW - Heart Septum/diagnostic imaging
KW - Heart Ventricles/diagnostic imaging
KW - Humans
KW - Male
KW - Middle Aged
KW - Stroke Volume
KW - Treatment Outcome
KW - Ultrasonography
U2 - 10.1016/j.hrthm.2012.11.007
DO - 10.1016/j.hrthm.2012.11.007
M3 - SCORING: Journal article
C2 - 23174486
VL - 10
SP - 354
EP - 360
JO - HEART RHYTHM
JF - HEART RHYTHM
SN - 1547-5271
IS - 3
ER -