| Cardiac resynchronization therapy: "nonresponders" and "hyperresponders". | |
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MedLine Citation:
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PMID: 18242538 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac resynchronization therapy (CRT) is a recognized treatment modality for patients with dilated cardiomyopathy (DCM), left bundle branch block, and severe cardiac failure. However, 30% of patients are "nonresponders." Intriguingly, the opposite case has not been reported until recently: Do some patients treated with CRT have a "complete" recovery and thus can be considered "hyperresponders"? OBJECTIVE: The purpose of this study was to investigate patients treated with CRT who have a "complete" functional recovery, with normalization of left ventricular function after therapy. METHODS: Eighty-four consecutive patients with DCM, sinus rhythm, and left bundle branch block in New York Heart Association functional class III and IV who were implanted with a CRT device were prospectively followed. Patients were considered to be "hyperresponders" if they concurrently fulfilled two criteria: functional recovery and left ventricular ejection fraction > or = 50%. RESULTS: Among the 84 patients with DCM, 11 (13%) were "hyperresponders" within 6 to 24 months after CRT (left ventricular ejection fraction increased from 25% +/- 8% to 60% +/- 6.5%, P = .001). Comparison of baseline parameters between "hyperresponders" and the remaining patients showed that only etiology of the DCM was statistically discriminative. All "hyperresponders" belonged to the group of patients with nonischemic DCM (18% vs 0%, P = .05). CONCLUSION: In a subset of patients successfully implanted with a CRT device, "complete" functional recovery associated with normalization of LV function was observed, giving rise to the concept of "hyperresponders." This finding is observed exclusively in the subgroup of patients with nonischemic DCM and suggests that left bundle branch block may be the causal factor of DCM in this subgroup of patients. |
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Authors:
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Philippe Castellant; Marjaneh Fatemi; Valerie Bertault-Valls; Yves Etienne; Jean-Jacques Blanc |
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Publication Detail:
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Type: Journal Article Date: 2007-10-02 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 5 ISSN: 1547-5271 ISO Abbreviation: Heart Rhythm Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-02-04 Completed Date: 2008-04-29 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 193-7 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Hôpital de la Cavale Blanche, Brest University Hospital, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block / physiopathology, therapy* Cardiac Pacing, Artificial* Cardiomyopathy, Dilated / physiopathology, therapy* Exercise Test Female Follow-Up Studies Heart Failure / physiopathology, therapy* Heart Ventricles / physiopathology Humans Incidence Male Middle Aged Myocardial Ischemia / physiopathology, therapy Prospective Studies Stroke Volume Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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