Time course of left ventricular reverse remodeling in response to pharmacotherapy: clinical implication for heart failure prognosis in patients with idiopathic dilated cardiomyopathy

2015 ◽  
Vol 31 (4) ◽  
pp. 545-554 ◽  
Author(s):  
Yuki Ikeda ◽  
Takayuki Inomata ◽  
Yuichiro Iida ◽  
Miwa Iwamoto-Ishida ◽  
Takeru Nabeta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Clinical Implication ◽  
Time Course ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Reverse Remodeling ◽  
Left Ventricular Reverse Remodeling ◽  
Failure Prognosis

Prognostic Impact of the Time Course of Left Ventricular Reverse Remodeling with Nonischemic Dilated Cardiomyopathy

2013 ◽  
Vol 19 (10) ◽  
pp. S149
Author(s):  
Takeru Nabeta ◽  
Takayuki Inomata ◽  
Yuichiro Iida ◽  
Yuuki Ikeda ◽  
Miwa Iwamoto ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Time Course ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Prognostic Impact ◽  
Left Ventricular Reverse Remodeling ◽  
Nonischemic Dilated Cardiomyopathy

Left Ventricular Reverse Remodeling in Long-Term (>12 Years) Survivors With Idiopathic Dilated Cardiomyopathy

2013 ◽  
Vol 111 (1) ◽  
pp. 106-110 ◽  
Author(s):  
Yoshihisa Matsumura ◽  
Eri Hoshikawa-Nagai ◽  
Toru Kubo ◽  
Naohito Yamasaki ◽  
Takashi Furuno ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Reverse Remodeling ◽  
Left Ventricular Reverse Remodeling

P173 CRT-induced left ventricular reverse remodeling in patients with congestive heart failure

2011 ◽  
Vol 10 ◽  
pp. S31
Author(s):  
N. Rogacheva ◽  
Yu.A. Schneider ◽  
P.V. Krasnoperov ◽  
V.A. Basova ◽  
S.R. Kuzmina-Krutetskaya ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Left Ventricular Reverse Remodeling

scholarly journals Analysis of Risk Factors for Acute Heart Failure in Patients with Dilated Cardiomyopathy and Persistent Severe Functional Mitral Regurgitation Despite Cardiac Resynchronization Therapy

2020 ◽  
pp. 35-39
Author(s):  
R. V. Buriak ◽  
K. V. Rudenko ◽  
O. A. Krykunov
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mitral Regurgitation ◽  
Cardiac Resynchronization Therapy ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Functional Mitral Regurgitation ◽  
Reverse Remodeling ◽  
Resynchronization Therapy

Congestive heart failure resulting from non-ischemic dilated cardiomyopathy (DCM) with secondary functional mitral regurgitation (FMR) is associated with poor prognosis. Medical treatment results in a 1-year survival of 52% to 87% and a 5-year survival of 22% to 54%, with highest survivals observed in more recent years, probably reflecting improvements in medical therapy. Non-surgical interventions involve cardiac resynchronization therapy. In addition to medical treatment, cardiac resynchronization therapy (CRT) should be considered in patients with New York Heart Association (NYHA) class II– IV HF, left ventricular ejection fraction (LVEF) =35%, normal sinus rhythm and left bundle branch block with QRS >150 ms. In these patients, CRT can also facilitate left ventricular (LV) reverse remodeling and reduce associated FMR. The aim of this study was to investigate the features of symptomatology and to analyze the risk factors for acute heart failure (AHF) in patients with DCM and persistent severe functional mitral regurgitation despite CRT and optimal guideline-directed medical therapy (GDMT). Materials and methods. After providing informed consent, 144 patients with severe FMR were involved in the study. Concomitant tricuspid valve regurgitation was registered in 142 (98.6%) cases. The median LVEF was 27.0 (23.0-31.6)%. 40 (27.8%) patients had a permanent form of atrial fibrillation, and 24 (16.7%) patients had a first-degree atrioventricular node block. The median NT-proBNP was 2600 (2133-3200) pg/ml, indicating the presence of severe chronic heart failure. Results. The median term after CRT device implantation was 36 (3.5-60) months. A comparative analysis between DCM patients with and without CRT revealed statistically significant differences between clinical characteristics, namely: age (p=0.020), lower heart rate (p=0.004), lower hemoglobin (p=0.017), higher erythrocyte sedimentation rate (ESR) (p=0.000) and more frequent AHF at the hospital stage (p=0.030). The incidence of AHF at the hospital stage was 13.8% in patients with CRT and 3.5% in those without CRT. The calculated odds ratio of AHF was 4.44 (95% confidence interval (CI) 1.039-18.971), and the relative risk of AHF was 3.966 (95% CI 1.054-14.915). Discussion. FMR has been reported to persist in about 20% to 25% of CRT patients and, in an additional 10% to 15%, it may actually worsen after CRT. In this subset of CRT non-responders, reduced reverse remodeling, increased morbidity, and increased mortality have been reported compared with CRT patients in whom FMR was significantly reduced or abolished. Conclusions. The results of our study demonstrate that severe functional mitral regurgitation despite cardiac resynchronization therapy in patients with dilated cardiomyopathy is a significant risk factor for AHF and subsequent hospitalizations for heart failure.

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