Document Detail

Survival in New York Heart Association class IV heart failure patients treated with cardiac resynchronization therapy compared with patients on optimal pharmacological treatment.
MedLine Citation:
PMID:  20543199     Owner:  NLM     Status:  MEDLINE    
AIMS: Although the benefit of cardiac resynchronization therapy (CRT) in selected patients with heart failure is well established, its effect on mortality in New York Heart Association (NYHA) class IV patients remains unclear. Our study evaluated the effect of CRT on urgent transplant-free survival in NYHA class IV patients treated with CRT, compared with medication-only treatment.
METHODS AND RESULTS: Forty NYHA class IV patients treated with CRT (80% men, 62.5% ischaemic, mean age of 65) were matched 1:1 by age, gender and aetiology of cardiomyopathy with patients treated with optimal medical therapy (OPT group). No significant differences were found between the groups in left ventricular diastolic diameter (71 +/- 6 vs. 73 +/- 9 mm), left ventricular systolic diameter (58 +/- 7 vs. 61 +/- 11 mm), and left ventricular ejection fraction (23 +/- 5 vs. 22 +/- 6%). Mean follow-up was 13.2 +/- 9.5 months for the CRT group and 17.3 +/- 11.6 months for the OPT group. Time to all-cause death or urgent transplantation [hazard ratios (HR), 1.29; 95% CI: 0.59-2.83; P = 0.52] or to cardiovascular death or urgent transplantation (HR, 1.53; 95% CI: 0.64-3.67; P = 0.34) was not reduced significantly in patients treated with CRT.
CONCLUSION: In this study, CRT did not significantly improve survival of NYHA class IV heart failure patients compared with pharmacological therapy.
María Angeles Castel; Santiago Magnani; Lluís Mont; Eulalia Roig; David Tamborero; Francisco Méndez-Zurita; José Francisco Femenia; José María Tolosana; Félix Pérez-Villa; Josep Brugada
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-12
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  12     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-11-16     Revised Date:  2010-12-06    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1136-40     Citation Subset:  IM    
Thorax Clinic Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Villarroel 170, Barcelona 08036, Spain.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Cardiac Pacing, Artificial / mortality*,  statistics & numerical data*
Death, Sudden, Cardiac / epidemiology
Defibrillators, Implantable / statistics & numerical data
Diuretics / therapeutic use
Follow-Up Studies
Heart Failure / drug therapy*,  mortality*
Heart Transplantation / mortality
Middle Aged
New York / epidemiology
Severity of Illness Index
Societies, Medical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics
Comment In:
Europace. 2010 Dec;12(12):1797; author reply 1797-8   [PMID:  20876275 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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