The association of mechanical dyssynchrony and resynchronization therapy with survival in heart failure with a wide QRS complex: a two-world study
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie, audiovizuální média
Grantová podpora
OT/12/085
University Hospitals Leuven
175099
Ministry of Science, Republic of Serbia
PubMed
32356183
DOI
10.1007/s10554-020-01865-x
PII: 10.1007/s10554-020-01865-x
Knihovny.cz E-zdroje
- Klíčová slova
- Apical rocking, Cardiac resynchronization therapy, Mechanical dyssynchrony, Septal flash, Survival,
- MeSH
- akční potenciály MeSH
- časové faktory MeSH
- echokardiografie MeSH
- funkce levé komory srdeční MeSH
- kardiovaskulární látky terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- obnova funkce MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční frekvence * MeSH
- srdeční resynchronizační terapie * škodlivé účinky mortalita MeSH
- srdeční selhání diagnostické zobrazování mortalita patofyziologie terapie MeSH
- tepový objem MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- audiovizuální média MeSH
- časopisecké články MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- kardiovaskulární látky MeSH
Setting up a randomized trial to assess the association of mechanical dyssynchrony (MD) and the success of cardiac resynchronization therapy (CRT) in heart failure with a wide QRS complex is ethically challenging. We therefore investigated this association in a retrospective cohort study observing different treatment strategies which were chosen based on the availability of health care resources. The survival of 500 patients from six Western European centers treated with CRT was compared to their 137 Eastern European counterparts not treated with CRT, with regard to the presence of MD. MD was visually assessed and was defined as the presence of apical rocking and/or septal flash. Patients were followed for a mean of 26 ± 8 months for the occurrence of death of any cause. As compared with medical therapy alone, CRT was associated with a more favorable survival (hazard ratio (HR), 0.53; 95% confidence interval (CI) 0.35-0.79; P = 0.002). Patients with MD treated by CRT had better survival than patients belonging to all other groups-they showed 72%, 66% and 56% reduction in all-cause mortality, respectively, compared to patients with MD not treated by CRT (HR 0.28; 95% CI 0.17-0.44), patients without MD treated by CRT (HR 0.34; 95% CI 0.22-0.52) and patients without MD not treated by CRT (HR 0.44; 95% CI 0.25-0.76). Patients with wide QRS complex who are treated with CRT have a significantly better survival when MD is present.
Cardiovascular Center Aalst OLV Clinic Aalst Belgium
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology Oslo University Hospital Rikshospitalet Oslo Norway
Klinik für Innere Medizin Und Kardiologie St Vinzenz Hospital Cologne Germany
Practice Steuber and Prinz Clemens August Str 15 49751 Sögel Germany
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