Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
In patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), three months of optimal therapy are recommended before considering a primary preventive implantable cardioverter-defibrillator (ICD). It is unclear which patients benefit from a prolonged waiting period under prot...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/22/5/2037 |
| _version_ | 1797473687445700608 |
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| author | Johanna Mueller-Leisse Johanna Brunn Christos Zormpas Stephan Hohmann Henrike Aenne Katrin Hillmann Jörg Eiringhaus Johann Bauersachs Christian Veltmann David Duncker |
| author_facet | Johanna Mueller-Leisse Johanna Brunn Christos Zormpas Stephan Hohmann Henrike Aenne Katrin Hillmann Jörg Eiringhaus Johann Bauersachs Christian Veltmann David Duncker |
| author_sort | Johanna Mueller-Leisse |
| collection | DOAJ |
| description | In patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), three months of optimal therapy are recommended before considering a primary preventive implantable cardioverter-defibrillator (ICD). It is unclear which patients benefit from a prolonged waiting period under protection of the wearable cardioverter-defibrillator (WCD) to avoid unnecessary ICD implantations. This study included all patients receiving a WCD for newly diagnosed HFrEF (<i>n</i> = 353) at our center between 2012 and 2017. Median follow-up was 2.7 years. From baseline until three months, LVEF improved in patients with all peripartum cardiomyopathy (PPCM), myocarditis, dilated cardiomyopathy (DCM), or ischemic cardiomyopathy (ICM). Beyond this time, LVEF improved in PPCM and DCM only (10 ± 8% and 10 ± 12%, respectively), whereas patients with ICM showed no further improvement. The patients with newly diagnosed HFrEF were compared to 29 patients with a distinct WCD indication, which is an explantation of an infected ICD. This latter group had a higher incidence of WCD shocks and poorer overall survival. All-cause mortality should be considered when deciding on WCD prescription. In patients with newly diagnosed HFrEF, the potential for delayed LVEF recovery should be considered when timing ICD implantation, especially in patients with PPCM and DCM. |
| first_indexed | 2024-03-09T20:20:57Z |
| format | Article |
| id | doaj.art-ff705413d30b47ce89704f85276e6c6d |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-09T20:20:57Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-ff705413d30b47ce89704f85276e6c6d2023-11-23T23:50:06ZengMDPI AGSensors1424-82202022-03-01225203710.3390/s22052037Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II SubstudyJohanna Mueller-Leisse0Johanna Brunn1Christos Zormpas2Stephan Hohmann3Henrike Aenne Katrin Hillmann4Jörg Eiringhaus5Johann Bauersachs6Christian Veltmann7David Duncker8Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyIn patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), three months of optimal therapy are recommended before considering a primary preventive implantable cardioverter-defibrillator (ICD). It is unclear which patients benefit from a prolonged waiting period under protection of the wearable cardioverter-defibrillator (WCD) to avoid unnecessary ICD implantations. This study included all patients receiving a WCD for newly diagnosed HFrEF (<i>n</i> = 353) at our center between 2012 and 2017. Median follow-up was 2.7 years. From baseline until three months, LVEF improved in patients with all peripartum cardiomyopathy (PPCM), myocarditis, dilated cardiomyopathy (DCM), or ischemic cardiomyopathy (ICM). Beyond this time, LVEF improved in PPCM and DCM only (10 ± 8% and 10 ± 12%, respectively), whereas patients with ICM showed no further improvement. The patients with newly diagnosed HFrEF were compared to 29 patients with a distinct WCD indication, which is an explantation of an infected ICD. This latter group had a higher incidence of WCD shocks and poorer overall survival. All-cause mortality should be considered when deciding on WCD prescription. In patients with newly diagnosed HFrEF, the potential for delayed LVEF recovery should be considered when timing ICD implantation, especially in patients with PPCM and DCM.https://www.mdpi.com/1424-8220/22/5/2037HFrEFheart failureWCD (wearable cardioverter-defibrillator)ICD (implantable cardioverter-defibrillator)LVEF (left ventricular ejection fraction)SCD (sudden cardiac death) |
| spellingShingle | Johanna Mueller-Leisse Johanna Brunn Christos Zormpas Stephan Hohmann Henrike Aenne Katrin Hillmann Jörg Eiringhaus Johann Bauersachs Christian Veltmann David Duncker Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy Sensors HFrEF heart failure WCD (wearable cardioverter-defibrillator) ICD (implantable cardioverter-defibrillator) LVEF (left ventricular ejection fraction) SCD (sudden cardiac death) |
| title | Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy |
| title_full | Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy |
| title_fullStr | Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy |
| title_full_unstemmed | Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy |
| title_short | Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy |
| title_sort | delayed improvement of left ventricular function in newly diagnosed heart failure depends on etiology a prolong ii substudy |
| topic | HFrEF heart failure WCD (wearable cardioverter-defibrillator) ICD (implantable cardioverter-defibrillator) LVEF (left ventricular ejection fraction) SCD (sudden cardiac death) |
| url | https://www.mdpi.com/1424-8220/22/5/2037 |
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