Cardiac resynchronization therapy and its role in the management of heart failure

McAloon, Christopher; Theodoreson, Mark D; Hayat, Sajad; Osman, Faizel

doi:10.12968/hmed.2017.78.6.312

Cited by 4 publications

(3 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LV assist devices [LVADs]) have been assessed for their efficacy in preventing or reversing AR after MI ( Tables 1 and 2 ). 18–57,139–158 Combined therapies of ACEi/ARBs, beta‐blockers, mineralocorticoid receptor antagonists, or sodium–glucose cotransporter 2 (SGLT2) inhibitors have demonstrated benefits or are under investigation in clinical trials for restraining LV AR 4,24,53,139 . However, these drugs are non‐specific for post‐ischaemic RR mechanisms, and their selection may vary depending on the RR stage.…”

Section: Interventions That Trigger Reverse Remodellingmentioning

confidence: 99%

Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function

Falcão‐Pires,

Ferreira,

Trindade

et al. 2024

European J of Heart Fail

View full text Add to dashboard Cite

Cardiovascular disease (CVD) is the leading cause of morbimortality in Europe and worldwide. CVD imposes a heterogeneous spectrum of cardiac remodelling, depending on the insult nature, that is, pressure or volume overload, ischaemia, arrhythmias, infection, pathogenic gene variant, or cardiotoxicity. Moreover, the progression of CVD‐induced remodelling is influenced by sex, age, genetic background and comorbidities, impacting patients' outcomes and prognosis. Cardiac reverse remodelling (RR) is defined as any normative improvement in cardiac geometry and function, driven by therapeutic interventions and rarely occurring spontaneously. While RR is the outcome desired for most CVD treatments, they often only slow/halt its progression or modify risk factors, calling for novel and more timely RR approaches. Interventions triggering RR depend on the myocardial insult and include drugs (renin–angiotensin–aldosterone system inhibitors, beta‐blockers, diuretics and sodium–glucose cotransporter 2 inhibitors), devices (cardiac resynchronization therapy, ventricular assist devices), surgeries (valve replacement, coronary artery bypass graft), or physiological responses (deconditioning, postpartum). Subsequently, cardiac RR is inferred from the degree of normalization of left ventricular mass, ejection fraction and end‐diastolic/end‐systolic volumes, whose extent often correlates with patients' prognosis. However, strategies aimed at achieving sustained cardiac improvement, predictive models assessing the extent of RR, or even clinical endpoints that allow for distinguishing complete from incomplete RR or adverse remodelling objectively, remain limited and controversial. This scientific statement aims to define RR, clarify its underlying (patho)physiologic mechanisms and address (non)pharmacological options and promising strategies to promote RR, focusing on the left heart. We highlight the predictors of the extent of RR and review the prognostic significance/impact of incomplete RR/adverse remodelling. Lastly, we present an overview of RR animal models and potential future strategies under pre‐clinical evaluation.

show abstract

Section: Interventions That Trigger Reverse Remodellingmentioning

confidence: 99%

Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function

Falcão‐Pires,

Ferreira,

Trindade

et al. 2024

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

“…However, heart failure continues to have a significant adverse impact on individual patients and the wider society. Cardiac resynchronization therapy (CRT) revolutionized the treatment for a well-defined subgroup of heart failure to reduce mortality and hospitalization by restoring the synchronicity of the intraventricular, interventricular, and atrioventricular contractions (4)(5)(6). The first-line approach involves implanting pacing leads into the left ventricles through the coronary sinus.…”

Section: Introductionmentioning

confidence: 99%

“…interventricular, and atrioventricular contractions ( 4 – 6 ). The first-line approach involves implanting pacing leads into the left ventricles through the coronary sinus.…”

Section: Introductionmentioning

confidence: 99%

A Novel Approach for Repetitive Dislocation of Transvenous Left Ventricular Leads During Cardiac Resynchronization Therapy Implantation by the Loop Technique

Zheng

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Cardiac resynchronization therapy (CRT) for heart failure requires transvenous insertion of a left ventricular pacing lead through the coronary sinus. However, repeated intraoperative dislocations often occur. Therefore, we describe a novel technique that uses the loop technique to treat patients with repeated intraoperative dislocations during transvenous left ventricular lead implantation to stabilize the lead in its final position. In five patients with repeated intraoperative dislocation during transvenous left ventricular lead implantation, the loop technique was successfully used to stabilize the lead in its final position. The pacing and sensing parameters were satisfactory in all patients at implantation and 12 months post-operatively. Compared with the pre-operative values, the 12-month post-operative values for the left ventricular ejection fraction were significantly increased and the left ventricular end systolic dimension and left ventricular end diastolic dimension were significantly decreased (P < 0.05). The left ventricular ejection fraction of these 5 patients increased by more than 15%. CRT significantly improved the left ventricular structure and function of these 5 patients. During the 1-, 3-, 6-, and 12-month follow-ups, no left ventricular lead dislocations were observed. This loop technique is safe and effective and can be considered for repeated intraoperative dislocation during transvenous left ventricular lead implantation through the coronary sinus of a CRT device.

show abstract

Real-World Economic Burden Among Patients With And Without Heart Failure Worsening After Cardiac Resynchronization Therapy

Chung

Rickard

et al. 2020

Adv Ther

View full text Add to dashboard Cite

Cardiac resynchronization therapy and its role in the management of heart failure

Cited by 4 publications

References 35 publications

Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function

Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function

A Novel Approach for Repetitive Dislocation of Transvenous Left Ventricular Leads During Cardiac Resynchronization Therapy Implantation by the Loop Technique

Real-World Economic Burden Among Patients With And Without Heart Failure Worsening After Cardiac Resynchronization Therapy

Contact Info

Product

Resources

About