This new analysis of the REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) clinical trial shows that patients whose heart failure stabilizes with CRT live longer, similar to patients whose condition improves with CRT. The manuscript was recently published in the
Heart failure impacts more than 6.5 million people in the
'It is commonly stated within the cardiology community that about a third of patients do not respond to CRT,' said
The progression of heart failure can be measured in a number of ways. Clinical Composite Score (CCS) is used to categorize patient outcomes as improved, unchanged (stabilized), or worsened, which is determined using clinical measures, heart failure status and patient symptoms. Similarly, left ventricular end systolic volume index (LVESVi) assesses the amount of blood remaining in the left ventricle after contracting to determine the heart's effectiveness at pumping blood to meet the body's needs. Since survival decreases as LVESVi rises, this measure has been shown to be an important predictor of long-term outcomes in patients.
Using the CCS (406 patients), more than half (56%) of patients with mild heart failure improved at one year, 30% remained unchanged (or stabilized), and 14% worsened; five-year mortality for improved or stabilized patients was 10% compared to 21% for worsened patients, p=0.01. Using the LVESVi measure (353 patients), there was a 73% decrease in the risk of dying at five years for CRT patients who stabilized or improved, compared to those whose condition worsened (i.e., five-year mortality for improved or stabilized patients was 8% compared to 30% for worsened patients, p
(C) 2021 Electronic News Publishing, source