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The Impact of Reverse Remodeling on Long Term Survival in Mildly Symptomatic Heart Failure Patients Receiving Cardiac Resynchronization Therapy: Results from the REVERSE study.
MedLine Citation:
PMID:  25460860     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Cardiac resynchronization therapy (CRT) decreases mortality, improves functional status and induces reverse left ventricular (LV) remodeling in selected populations with heart failure (HF). The magnitude of reverse remodeling predicts survival with many HF medical therapies. However, there are little data assessing the impact of remodeling on long term survival with CRT.
OBJECTIVE: To assess the impact of CRT induced reverse remodeling on long term survival in mild HF.
METHODS: REVERSE was a multi-center, double-blind, randomized trial of CRT among patients with mild HF. Long-term follow-up for 5 years was pre-planned. The present analysis was confined to the 353 patients who were randomized to CRT ON with paired echocardiographic studies at baseline and 6 months post-implant. Left ventricular end systolic volume index (LVESVi) was measured by a core laboratory and was an independently powered endpoint of REVERSE.
RESULTS: A 68% reduction in mortality was observed among patients with ≥15% decrease in LVESVi compared to the rest of the patients (p=0.0004). Multivariable analysis showed that the change in LVESVi was a strong independent predictor (p=0.0002) with a 14% reduction of mortality for every 10% decrease of LVESVi. Other remodeling parameters, including left ventricular end diastolic volume index and ejection fraction showed a similar relationship with mortality.
CONCLUSION: Change in left ventricular end systolic volume over 6 months of CRT is a strong independent predictor of long term survival in mild HF.
CLINICAL TRIAL REGISTRATION: URL: http://clinicaltrials.gov/ct2/show/NCT00271154. Unique identifier: NCT00271154.
Authors:
Michael R Gold; Claude Daubert; William T Abraham; Stefano Ghio; Martin St John Sutton; John Harrison Hudnall; Jeff Cerkvenik; Cecilia Linde
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-15
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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