| Effects of cardiac resynchronisation therapy in patients with heart failure having a narrow QRS Complex enrolled in PROSPECT. | |
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MedLine Citation:
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PMID: 20610457 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Current guidelines recommend cardiac resynchronisation therapy (CRT) in patients with severe symptomatic heart failure, depressed left ventricular (LV) systolic function and a wide QRS complex (>or=120 ms). However, patients with heart failure having a narrow QRS complex might also benefit from CRT. DESIGN SETTING PATIENTS INTERVENTIONS: During the Predictors of Response to Cardiac Resynchronisation Therapy (PROSPECT) trial, 41 patients were enrolled in a 'narrow' QRS sub-study. These patients had a QRS complex <130 ms, but documented evidence of mechanical dyssynchrony by any of seven pre-defined echocardiographic measures. RESULTS: After 6 months of CRT, 26 (63.4%) patients showed improvement according to the Clinical Composite Score, 4 (9.8%) remained unchanged and 11 (26.8%) worsened. In patients with paired data, the 6-min walking distance increased from 334+/-118 m to 382+/-128 m, (p=0.003) and quality-of-life score improved from 44.2+/-19.7 to 26.8+/-20.2 (p<0.0001). Furthermore, there was a significant decrease in LV end-systolic diameter (from 59+/-9 to 55+/-12 mm, p=0.002) and in LV end-diastolic diameter (from 67+/-9 to 63+/-11 mm, p=0.007). CONCLUSION: The results suggest that CRT may have a beneficial effect in heart failure patients with a narrow QRS complex and mechanical dyssynchrony as assessed by echocardiography. The majority of patients improved on clinical symptoms, and there was an evident reduction in LV diameters. Larger studies are needed to clearly define selection criteria for CRT in patients with a narrow QRS complex. |
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Authors:
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R J van Bommel; J Gorcsan; E S Chung; W T Abraham; F T Gjestvang; C Leclercq; M J Monaghan; P Nihoyannopoulos; C Peraldo; C-M Yu; M Demas; B Gerritse; J J Bax |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 96 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-08-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 1107-13 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. j.j.bax@lumc.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arrhythmias, Cardiac / complications, physiopathology, therapy, ultrasonography Cardiac Pacing, Artificial / methods* Electrocardiography Female Follow-Up Studies Heart Failure / complications, physiopathology, therapy*, ultrasonography Humans Male Middle Aged Stroke Volume / physiology Treatment Outcome Ventricular Dysfunction, Left / complications, physiopathology, ultrasonography |
| Grant Support | |
ID/Acronym/Agency:
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K24HL04503-01/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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