The clinical outcome of cardiac resynchronization therapy in post-surgical valvular cardiomyopathy

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
Francisco LeyvaMichael P Frenneaux

Abstract

Trials have shown that cardiac resynchronization therapy (CRT) is effective in patients with 'non-ischaemic cardiomyopathy'. Patients with post-surgical valvular cardiomyopathy (PSVCM) have been excluded from such trials. We sought to compare the clinical outcome of CRT in patients with PSVCM, idiopathic dilated cardiomyopathy (IDCM), or ischaemic cardiomyopathy (ICM). Clinical events and response to CRT were quantified in 556 patients (PSVCM = 38; IDCM = 165; ICM = 353) over 4.52 years [median, inter-quartile range (IQR): 4.42]. Response to CRT was defined as survival for ≥1 year free of hospitalizations plus improvement by ≥1 NYHA class or ≥25% in 6-min walking distance. Cardiac resynchronization therapy was initiated at 5.86 years (median, IQR: 9.86) after aortic valve replacement (73.7%) or mitral valve replacement/repair (44.7%). Compared with PSVCM, IDCM was associated with a lower total mortality [hazards ratio, HR: 0.54 (95% confidence interval, CI 0.34-0.84)], cardiac mortality [HR: 0.43 (95% CI 0.26-0.70)], and total mortality or major adverse cardiovascular events [HR: 0.57 (95% CI 0.37-0.87)], independent of known confounders. Compared with PSVCM, ICM was associated with a similar risk of death from pump failure [HR...Continue Reading

References

Apr 12, 2003·Pacing and Clinical Electrophysiology : PACE·Maurizio GaspariniEdoardo Gronda
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
Mar 9, 2005·The New England Journal of Medicine·John G F ClelandUNKNOWN Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators
Oct 19, 2006·Journal of the American College of Cardiology·John J HayesUNKNOWN DAVID Investigators
Nov 23, 2006·Journal of the American College of Cardiology·Ravi G AssomullDudley J Pennell
Jul 22, 2009·American Heart Journal·Marcos GutiérrezEric Dumont
Sep 3, 2009·European Heart Journal·Kenneth DicksteinUNKNOWN National Coordinators
Dec 9, 2010·Interactive Cardiovascular and Thoracic Surgery·Iain G MatthewsAndrew J Turley
Jun 15, 2011·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Francisco LeyvaAngelo Auricchio
Nov 13, 2014·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Gerhard SchymikArmin Luik

❮ Previous
Next ❯

Citations

Jul 2, 2017·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·Sérgio BarraSharad Agarwal

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.