Outcome of super-responders to cardiac resynchronization therapy defined by endpoint-derived parameters of left ventricular remodeling: a two-center retrospective study

Hürlimann, David; Schmidt, Susann; Seifert, Burkhardt; Saguner, Ardan M.; Hindricks, Gerhard; Lüscher, Thomas F.; Ruschitzka, Frank; Steffel, Jan

doi:10.1007/s00392-014-0763-6

Cited by 4 publications

(2 citation statements)

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“…For patients with an indication for CCM and with symptomatic PVCs, it will be interesting to see if CCM might avert the need for PVC ablation [ 25 ]. It would also be of value to examine structural characteristics of the failing heart that might identify super responders, as has been done for CRT [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of long-term cardiac contractility modulation (CCM) in subjects with heart failure caused by left ventricular systolic dysfunction

et al. 2017

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IntroductionHeart failure is a major cause of morbidity and mortality throughout the world. Despite advances in therapy, nearly half of patients receiving guideline-directed medical therapy remain limited by symptoms. Cardiac contractility modulation (CCM) can improve symptoms in this population, but efficacy and safety in prospective studies has been limited to 12 months of follow-up. We report on the first 2 year multi-site evaluation of CCM in patients with heart failure.MethodsOne hundred and forty-three subjects with heart failure and reduced ejection fraction were followed via clinical registry for 24 months recording NYHA class, MLWHFQ score, 6 min walk distance, LVEF, and peak VO2 at baseline and 6 month intervals as clinically indicated. Serious adverse events, and all cause as well as cardiovascular mortality were recorded. Data are presented stratified by LVEF (all subjects, LVEF <35%, LVEF ≥35%).ResultsOne hundred and six subjects from 24 sites completed the 24 month follow-up. Baseline parameters were similar among LVEF groups. NYHA and MLWHFQ improved in all 3 groups at each time point. LVEF in the entire cohort improved 2.5, 2.9, 5.0, and 4.9% at 6, 12, 18, and 24 months, respectively. Insufficient numbers of subjects had follow-up data for 6 min walk or peak VO2 assessment, precluding comparative analysis. Serious adverse events (n = 193) were observed in 91 subjects and similarly distributed between groups with LVEF <35% and LVEF ≥35%, and similar to other device trials for heart failure. Eighteen deaths (7 cardiovascularly related) over 2 years. Overall survival at 2 years was 86.4% (95% confidence intervals: 79.3, 91.2%).ConclusionCardiac contractility modulation provides safe and effective long-term symptomatic and functional improvement in heart failure. These benefits were independent of baseline LVEF and were associated with a safety profile similar to published device trials.

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Section: Discussionmentioning

confidence: 99%

Clinical effects of long-term cardiac contractility modulation (CCM) in subjects with heart failure caused by left ventricular systolic dysfunction

et al. 2017

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“…В более поздних работах авторы также использовали динамику ФВ ЛЖ, как критерий «суперответа», однако целевой уровень ФВ ЛЖ менял-ся от исследования к исследованию [17][18][19]. До сих пор нет единого мнения о том, какого критерия следует при-держиваться при определении понятия «суперреспон-дер» [20][21][22][23]. В нашем исследовании, как и в ряде других крупных исследований, пациенты были отнесены в груп-пу «суперреспондеров», если через 6 мес после имплан-тации снижение КСО ЛЖ составило 30 % и более [16,24,25].…”

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A “superresponse” to cardiac resynchronization therapy in patients with chronic heart failure

Kuznetsov¹,

Melnikov²,

Krinochkin³

et al. 2015

RHFJ

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Sustained clinical benefit of cardiac resynchronization therapy in non-LBBB patients with prolonged PR-interval: MADIT-CRT long-term follow-up

et al. 2016

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Outcome of super-responders to cardiac resynchronization therapy defined by endpoint-derived parameters of left ventricular remodeling: a two-center retrospective study

Abstract: NPV- and best quartile-based cut-offs validate previously applied empirical echocardiographic cut-offs to define super-response to CRT. These data provide evidence for using these empirical cut-offs in daily practice and facilitate inter-study comparability.

Cited by 4 publications

References 16 publications

Clinical effects of long-term cardiac contractility modulation (CCM) in subjects with heart failure caused by left ventricular systolic dysfunction

Clinical effects of long-term cardiac contractility modulation (CCM) in subjects with heart failure caused by left ventricular systolic dysfunction

A “superresponse” to cardiac resynchronization therapy in patients with chronic heart failure

Sustained clinical benefit of cardiac resynchronization therapy in non-LBBB patients with prolonged PR-interval: MADIT-CRT long-term follow-up

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