Abstract 4346: CRT In Mild Heart Failure: Left Ventricular Remodeling In Relation To Heart Failure Etiology. Results From The Resynchronization Reverses Remodeling In Systolic Left Ventricular Dysfunctie (reverse) Study
Background: Cardiac resynchronisation therapy (CRT) induces progressive reverse left ventricular (LV) remodeling and slows disease progression in NYHA III-IV patients (pts) with a more pronounced effect on remodeling in non-ischemic patients. We hypothesized that CRT might also be beneficial in NYHA class I/II pts and with a similar relationship to heart failure (HF) etiology.
Method: The REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) study design and 12 month results have previously been reported. The results of LV reverse remodeling in relation to HF etiology are reported here.
Results: 610 pts in NYHA II (82.3%) HF or NYHA I (17.7%) were randomized in 73 centers in the US, Canada and Europe. Of 277 non-ischemic patients, 94 were assigned to CRT OFF and 183 to CRT ON. Of 333 ischemic patients, 97 were assigned to CRT OFF and 236 to CRT ON. The effect of CRT on LV remodelling is shown in the table⇓. The first four columns of this table show the mean changes from baseline to 12 months. Significant interactions (last column) were found in LVESVi and LVEF indicating that, although ischemic patients improved with CRT, non-ischemic patients improved more than ischemic patients. Statistically significant improvements using CRT (Rand. column) regardless of etiology were seen in LVESVi, LVEDVi, LVEF, and IVMD.
Conclusion: Though improvement was seen in both etiologies, the extent of LV reverse remodeling in non-ischemic patients was greater, on average, than that observed in ischemic patients.