Ventricular Remodeling Extent Linked to Outcomes

More extensive remodeling after cardiac resynchronization associated with better outcomes

TUESDAY, Feb. 3 (HealthDay News) -- Heart failure patients with more extensive left ventricular reverse remodeling after cardiac resynchronization therapy have better outcomes such as improvements in left ventricular function, fewer hospitalizations and reduced mortality, researchers report in the Feb. 10 issue of the Journal of the American College of Cardiology.

Claudia Ypenburg, M.D., from Leiden University Medical Center in the Netherlands, and colleagues examined outcomes based on the extent of left ventricular reverse remodeling in 302 heart failure patients who received cardiac resynchronization therapy. The extent of remodeling was assessed by left ventricular end-systolic volume (LVESV).

After six months of treatment, the researchers found that patients who had more extensive left ventricular reverse remodeling (the 57 percent of patients classified as responders or super-responders based on reductions in LVESV) had a greater increase in left ventricular function and a greater reduction in mitral regurgitation. After a mean follow-up of 22 months, patients with more extensive remodeling also had fewer hospitalizations for heart failure and reduced mortality, where the super-responders had a two-year hospitalization-free survival rate of 96 percent compared with 70 percent for the negative responders (patients with an increase in LVESV), the report indicates.

"The extent of left ventricular reverse remodeling at midterm follow-up is predictive for long-term outcome in cardiac resynchronization therapy patients," Ypenburg and colleagues conclude.

Authors of the study disclose financial relationships with pharmaceutical and medical companies.

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