Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy
Aim. To assess the clinical course and cardiac reverse remodeling in patients with heart failure (HF) with reduced ejection fraction (HFrEF) receiving cardiac contractility modulation (CCM) therapy.Material and methods. Fifty-five patients (mean age, 53±11 years, 46 males) with NYHA class II-III HFr...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
«FIRMA «SILICEA» LLC
2021-02-01
|
| Series: | Российский кардиологический журнал |
| Subjects: | |
| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4035 |
| _version_ | 1797856671467307008 |
|---|---|
| author | M. A. Vander E. A. Lyasnikova L. A. Belyakova M. A. Trukshina V. L. Galenko I. M. Kim T. A. Lelyavina M. L. Abramov T. A. Lyubimtseva M. Yu. Sitnikova D. S. Lebedev E. N. Mikhaylov |
| author_facet | M. A. Vander E. A. Lyasnikova L. A. Belyakova M. A. Trukshina V. L. Galenko I. M. Kim T. A. Lelyavina M. L. Abramov T. A. Lyubimtseva M. Yu. Sitnikova D. S. Lebedev E. N. Mikhaylov |
| author_sort | M. A. Vander |
| collection | DOAJ |
| description | Aim. To assess the clinical course and cardiac reverse remodeling in patients with heart failure (HF) with reduced ejection fraction (HFrEF) receiving cardiac contractility modulation (CCM) therapy.Material and methods. Fifty-five patients (mean age, 53±11 years, 46 males) with NYHA class II-III HFrEF (ischemic etiology in 73% of patients), sinus rhythm, QRS<130 ms or QRS<150 ms of non-LBBB morphology receiving optimal medical therapy were enrolled into the study. CCM devices were implanted to all patients between October 2016 and September 2017. We assessed the following parameters: hospitalizations and mortality due to decompensated HF; changes in HF class, NTproBNP concentration, peak oxygen consumption, six-minute walk test, left ventricular end-systolic and end-diastolic volumes and ejection fraction (EF), atrial and ventricular arrhythmias. A comparative analysis of the studied parameters was carried out depending on the pacing with one and two ventricular leads, on LVEF value (>25% and <25%) and HF etiology.Results. CCM therapy was associated with a decrease in HF class (p<0,00004001), HF-related hospitalization rate (p<0,0001001), blood NTproBNP concentration (p<0,018), an increase in peak oxygen consumption during the first year (p<0,006011), as well as a decrease in LV volumes and a LVEF increase (p<0,0001001). The direction of these changes did not depend on the number of ventricular leads and LVEF. The presence of ischemic cardiomyopathy and old myocardial infarction did not affect the disease prognosis, but was associated with a lower change in LV volumes and NTproBNP during 24 months of CCM therapy. LVEF values were significantly higher in the group of patients with HFrEF not associated with coronary artery disease after 12 and 24 months of follow-up.Conclusion. In the group of patients with class II-III HFrEF, CCM therapy in most patients was associated with improved clinical and hemodynamic status, increased exercise tolerance, decreased HF-related hospitalization rate, positive echocardiographic and NTproBNP changes. |
| first_indexed | 2024-04-09T20:44:19Z |
| format | Article |
| id | doaj.art-2d3020c0823a48748cb8d004e8c35f25 |
| institution | Directory Open Access Journal |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| last_indexed | 2024-04-09T20:44:19Z |
| publishDate | 2021-02-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj.art-2d3020c0823a48748cb8d004e8c35f252023-03-29T21:23:37Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-02-0126110.15829/1560-4071-2021-40353069Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapyM. A. Vander0E. A. Lyasnikova1L. A. Belyakova2M. A. Trukshina3V. L. Galenko4I. M. Kim5T. A. Lelyavina6M. L. Abramov7T. A. Lyubimtseva8M. Yu. Sitnikova9D. S. Lebedev10E. N. Mikhaylov11Almazov National Medical Research CenterAlmazov National Medical Research CenterFirst Pavlov State Medical UniversityAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAim. To assess the clinical course and cardiac reverse remodeling in patients with heart failure (HF) with reduced ejection fraction (HFrEF) receiving cardiac contractility modulation (CCM) therapy.Material and methods. Fifty-five patients (mean age, 53±11 years, 46 males) with NYHA class II-III HFrEF (ischemic etiology in 73% of patients), sinus rhythm, QRS<130 ms or QRS<150 ms of non-LBBB morphology receiving optimal medical therapy were enrolled into the study. CCM devices were implanted to all patients between October 2016 and September 2017. We assessed the following parameters: hospitalizations and mortality due to decompensated HF; changes in HF class, NTproBNP concentration, peak oxygen consumption, six-minute walk test, left ventricular end-systolic and end-diastolic volumes and ejection fraction (EF), atrial and ventricular arrhythmias. A comparative analysis of the studied parameters was carried out depending on the pacing with one and two ventricular leads, on LVEF value (>25% and <25%) and HF etiology.Results. CCM therapy was associated with a decrease in HF class (p<0,00004001), HF-related hospitalization rate (p<0,0001001), blood NTproBNP concentration (p<0,018), an increase in peak oxygen consumption during the first year (p<0,006011), as well as a decrease in LV volumes and a LVEF increase (p<0,0001001). The direction of these changes did not depend on the number of ventricular leads and LVEF. The presence of ischemic cardiomyopathy and old myocardial infarction did not affect the disease prognosis, but was associated with a lower change in LV volumes and NTproBNP during 24 months of CCM therapy. LVEF values were significantly higher in the group of patients with HFrEF not associated with coronary artery disease after 12 and 24 months of follow-up.Conclusion. In the group of patients with class II-III HFrEF, CCM therapy in most patients was associated with improved clinical and hemodynamic status, increased exercise tolerance, decreased HF-related hospitalization rate, positive echocardiographic and NTproBNP changes.https://russjcardiol.elpub.ru/jour/article/view/4035cardiac contractility modulationheart failurereduced ejection fraction |
| spellingShingle | M. A. Vander E. A. Lyasnikova L. A. Belyakova M. A. Trukshina V. L. Galenko I. M. Kim T. A. Lelyavina M. L. Abramov T. A. Lyubimtseva M. Yu. Sitnikova D. S. Lebedev E. N. Mikhaylov Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy Российский кардиологический журнал cardiac contractility modulation heart failure reduced ejection fraction |
| title | Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy |
| title_full | Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy |
| title_fullStr | Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy |
| title_full_unstemmed | Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy |
| title_short | Dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy |
| title_sort | dynamics of heart failure markers and cardiac reverse remodeling in patients receiving cardiac contractility modulation therapy |
| topic | cardiac contractility modulation heart failure reduced ejection fraction |
| url | https://russjcardiol.elpub.ru/jour/article/view/4035 |
| work_keys_str_mv | AT mavander dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT ealyasnikova dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT labelyakova dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT matrukshina dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT vlgalenko dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT imkim dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT talelyavina dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT mlabramov dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT talyubimtseva dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT myusitnikova dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT dslebedev dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy AT enmikhaylov dynamicsofheartfailuremarkersandcardiacreverseremodelinginpatientsreceivingcardiaccontractilitymodulationtherapy |