Document Detail


Is "hyper response" to cardiac resynchronization therapy in patients with nonischemic cardiomyopathy a recovery, a remission, or a control?
MedLine Citation:
PMID:  20946554     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Some patients treated by cardiac resynchronization therapy (CRT) recover "normal" left ventricular (LV) function and functional status. However, whether this "normalization" persists or reverts over time remains unknown. The aim of the present study was to evaluate the long-term outcomes of LV function in patients hyper responder to CRT.
METHODS: Eleven consecutive patients with nonischemic dilated cardiomyopathy, sinus rhythm, left bundle branch block (LBBB), New York Heart Association (NYHA) class III or IV, and optimal pharmacological treatment were hyper responder as they fulfilled concurrently the two following criteria: functional recovery (NYHA class I or II) and normalization of LV ejection fraction (LVEF).
RESULTS: After a mean follow-up of 65 ± 30 months between CRT implantation and last evaluation LVEF improved from 26 ± 9 to 59 ± 6% (P < 0.0001). One patient died from pulmonary embolism 31 months after implantation. Three patients exhibited LVEF ≤ 50% at their last follow-up visit (two at 40% and one at 45%). In eight patients, brief cessation of pacing was feasible (three were pacemaker-dependent). Mean QRS duration decreased from 181 ± 23 ms to 143 ± 22 ms (P = 0.006). In one patient, pacing was interrupted for 2 years and LVEF decreased markedly (from 65% to 31%) but returned to normal after a few months when pacing was resumed.
CONCLUSION: In hyper responder patients, "normalization" of LV function after CRT persists as long as pacing is maintained with an excellent survival.
Authors:
Philippe Castellant; Erwann Orhan; Valerie Bertault-Valls; Marjaneh Fatemi; Yves Etienne; Jean-Jacques Blanc
Related Documents :
16464914 - The prognostic impact of coronary flow-reserve assessed by doppler echocardiography in ...
10925734 - Heat shock protein 72 expression in the right ventricle of patients undergoing congenit...
2950254 - Endomyocardial biopsy findings in pediatric patients with post myocarditic state.
7412774 - Echocardiography in duchenne muscular dystrophy.
21308374 - Quantification of neutrophil migration into the lungs of patients with chronic obstruct...
19528244 - Lower levels of tsh are associated with a lower risk of papillary thyroid cancer in pat...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  15     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  321-7     Citation Subset:  IM    
Copyright Information:
©2010, Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Hôpital de la Cavale Blanche, Brest University Hospital, Boulevard Tanguy Prigent, Brest Cedex, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Relationship between resting electrocardiographic parameters and estimated 10-year risk for coronary...
Next Document:  Identification of gender-related normality regions for T-wave alternans.