Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy
Abstract Aims Echocardiographic response after cardiac resynchronization therapy (CRT) is often lesser in ischaemic cardiomyopathy (ICM) than non‐ischaemic dilated cardiomyopathy (NIDCM) patients. We assessed the association of heart failure aetiology on the amount of reverse remodelling and outcome...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-04-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12624 |
| _version_ | 1819002973480550400 |
|---|---|
| author | Mariëlle Kloosterman Antonius M.W. vanStipdonk Iris terHorst Michiel Rienstra Isabelle C. Van Gelder Marc A. Vos Frits W. Prinzen Matthias Meine Kevin Vernooy Alexander H. Maass |
| author_facet | Mariëlle Kloosterman Antonius M.W. vanStipdonk Iris terHorst Michiel Rienstra Isabelle C. Van Gelder Marc A. Vos Frits W. Prinzen Matthias Meine Kevin Vernooy Alexander H. Maass |
| author_sort | Mariëlle Kloosterman |
| collection | DOAJ |
| description | Abstract Aims Echocardiographic response after cardiac resynchronization therapy (CRT) is often lesser in ischaemic cardiomyopathy (ICM) than non‐ischaemic dilated cardiomyopathy (NIDCM) patients. We assessed the association of heart failure aetiology on the amount of reverse remodelling and outcome of CRT. Methods and results Nine hundred twenty‐eight CRT patients were retrospectively included. Reverse remodelling and endpoint occurrence (all‐cause mortality, heart transplantation, or left ventricular assist device implantation) was assessed. Two response definitions [≥15% reduction left ventricular end systolic volume (LVESV) and ≥5% improvement left ventricular ejection fraction] and the most accurate cut‐off for the amount of reverse remodelling that predicted endpoint freedom were assessed. Mean follow‐up was 3.8 ± 2.4 years. ICM was present in 47%. ICM patients who were older (69 ± 7 vs. 63 ± 11), more often men (83% vs. 58%), exhibited less LVESV reduction (13 ± 31% vs. 23 ± 32%) and less left ventricular ejection fraction improvement (5 ± 11% vs. 10 ± 12%) than NIDCM patients (all P < 0.001). Nevertheless, every 1% LVESV reduction was associated with a relative reduction in endpoint occurrence: NIDCM 1.3%, ICM 0.9%, and absolute risk reduction was similar (0.4%). The most accurate cut‐off of LVESV reduction that predicted endpoint freedom was 17.1% in NIDCM and 13.2% in ICM. Conclusions ICM patients achieve less reverse remodelling than NIDCM, but the prognostic gain in terms of survival time is the same for every single percentage of reverse remodelling that does occur. The assessment and expected magnitude of reverse remodelling should take this effect of heart failure aetiology into account. |
| first_indexed | 2024-12-20T23:13:37Z |
| format | Article |
| id | doaj.art-a4eca2fb28834df986bc7cd6d0acbb3c |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-20T23:13:37Z |
| publishDate | 2020-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-a4eca2fb28834df986bc7cd6d0acbb3c2022-12-21T19:23:40ZengWileyESC Heart Failure2055-58222020-04-017264565310.1002/ehf2.12624Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapyMariëlle Kloosterman0Antonius M.W. vanStipdonk1Iris terHorst2Michiel Rienstra3Isabelle C. Van Gelder4Marc A. Vos5Frits W. Prinzen6Matthias Meine7Kevin Vernooy8Alexander H. Maass9Department of Cardiology University of Groningen, University Medical Centre Groningen PO Box 30.001 Groningen 9700 RB The NetherlandsDepartment of Cardiology Maastricht University Medical Center Maastricht the NetherlandsDepartment of Cardiology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Cardiology University of Groningen, University Medical Centre Groningen PO Box 30.001 Groningen 9700 RB The NetherlandsDepartment of Cardiology University of Groningen, University Medical Centre Groningen PO Box 30.001 Groningen 9700 RB The NetherlandsDepartment of Medical Physiology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Physiology, Cardiovascular Research Institute Maastricht (CARIM) University of Maastricht Maastricht the NetherlandsDepartment of Cardiology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Cardiology Maastricht University Medical Center Maastricht the NetherlandsDepartment of Cardiology University of Groningen, University Medical Centre Groningen PO Box 30.001 Groningen 9700 RB The NetherlandsAbstract Aims Echocardiographic response after cardiac resynchronization therapy (CRT) is often lesser in ischaemic cardiomyopathy (ICM) than non‐ischaemic dilated cardiomyopathy (NIDCM) patients. We assessed the association of heart failure aetiology on the amount of reverse remodelling and outcome of CRT. Methods and results Nine hundred twenty‐eight CRT patients were retrospectively included. Reverse remodelling and endpoint occurrence (all‐cause mortality, heart transplantation, or left ventricular assist device implantation) was assessed. Two response definitions [≥15% reduction left ventricular end systolic volume (LVESV) and ≥5% improvement left ventricular ejection fraction] and the most accurate cut‐off for the amount of reverse remodelling that predicted endpoint freedom were assessed. Mean follow‐up was 3.8 ± 2.4 years. ICM was present in 47%. ICM patients who were older (69 ± 7 vs. 63 ± 11), more often men (83% vs. 58%), exhibited less LVESV reduction (13 ± 31% vs. 23 ± 32%) and less left ventricular ejection fraction improvement (5 ± 11% vs. 10 ± 12%) than NIDCM patients (all P < 0.001). Nevertheless, every 1% LVESV reduction was associated with a relative reduction in endpoint occurrence: NIDCM 1.3%, ICM 0.9%, and absolute risk reduction was similar (0.4%). The most accurate cut‐off of LVESV reduction that predicted endpoint freedom was 17.1% in NIDCM and 13.2% in ICM. Conclusions ICM patients achieve less reverse remodelling than NIDCM, but the prognostic gain in terms of survival time is the same for every single percentage of reverse remodelling that does occur. The assessment and expected magnitude of reverse remodelling should take this effect of heart failure aetiology into account.https://doi.org/10.1002/ehf2.12624Cardiac resynchronization therapyEchocardiographyClinical responseAetiology |
| spellingShingle | Mariëlle Kloosterman Antonius M.W. vanStipdonk Iris terHorst Michiel Rienstra Isabelle C. Van Gelder Marc A. Vos Frits W. Prinzen Matthias Meine Kevin Vernooy Alexander H. Maass Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy ESC Heart Failure Cardiac resynchronization therapy Echocardiography Clinical response Aetiology |
| title | Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy |
| title_full | Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy |
| title_fullStr | Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy |
| title_full_unstemmed | Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy |
| title_short | Association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy |
| title_sort | association between heart failure aetiology and magnitude of echocardiographic remodelling and outcome of cardiac resynchronization therapy |
| topic | Cardiac resynchronization therapy Echocardiography Clinical response Aetiology |
| url | https://doi.org/10.1002/ehf2.12624 |
| work_keys_str_mv | AT mariellekloosterman associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT antoniusmwvanstipdonk associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT iristerhorst associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT michielrienstra associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT isabellecvangelder associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT marcavos associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT fritswprinzen associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT matthiasmeine associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT kevinvernooy associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy AT alexanderhmaass associationbetweenheartfailureaetiologyandmagnitudeofechocardiographicremodellingandoutcomeofcardiacresynchronizationtherapy |