Document Detail


Cardiac resynchronization therapy may benefit patients with left ventricular ejection fraction >35%: a PROSPECT trial substudy.
MedLine Citation:
PMID:  20150328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Cardiac resynchronization therapy (CRT) is currently limited to those with left ventricular ejection fraction (LVEF) < or =35%. To evaluate whether patients with LVEF >35% might benefit from CRT, we performed a retrospective analysis of the predictors of response to CRT (PROSPECT) database.
METHODS AND RESULTS: PROSPECT was a prospective, multicentre study that enrolled CRT patients based on enrolling centre-evaluated LVEF <35%, but all echocardiograms were subsequently analysed by a core laboratory. Patients with core laboratory-measured LVEF >35% (OVER35) were compared with those whose LVEF was <35% (UNDER35). Clinical composite score (CCS) and change in LV end systolic volume (LVESV) were analysed from baseline to 6-month follow-up. Of 361 patients, 86 (24%) had LVEF >35%. At entry, OVER35 had smaller LV volumes, shorter QRS duration, shorter 6-min walk distance, and were more likely to have ischaemic aetiology than UNDER35. Outcomes were comparable between the groups, with 62.8% of OVER35 improved in CCS (70.2% in UNDER35) and 50.8% of OVER35 improved in LVESV (57.8% in UNDER35).
CONCLUSION: Patients with LVEF >35%, New York heart association functional Class III-IV status, and QRS >130 ms appear to derive clinical and structural benefit from CRT. As CRT may offer a valuable option for these patients, this hypothesis should be formally tested in a prospective, randomized multicentre trial.
Authors:
Eugene S Chung; Rodolphe P Katra; Stefano Ghio; Jeroen Bax; Bart Gerritse; Kathryn Hilpisch; Brett J Peterson; David S Feldman; William T Abraham
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-11
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-20     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  581-7     Citation Subset:  IM    
Affiliation:
The Christ Hospital and The Ohio Heart and Vascular Center, 2123 Auburn Avenue, Ste 100, Cincinnati, OH, USA. chunge@ohioheart.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial*
Female
Heart Failure / physiopathology,  therapy*
Humans
Male
Middle Aged
Retrospective Studies
Stroke Volume
Comments/Corrections
Comment In:
Eur J Heart Fail. 2010 Jun;12(6):527-9   [PMID:  20498266 ]
Eur J Heart Fail. 2010 Oct;12(10):1140-1; author reply 1141   [PMID:  20810474 ]

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