Effect of cardiac resynchronization therapy on sleep quality, quality of life, and symptomatic depression in patients with chronic heart failure and Cheyne-Stokes respiration

2005 ◽  
Vol 9 (4) ◽  
pp. 159-166 ◽  
Author(s):  
Erik C. Skobel ◽  
Anil-Martin Sinha ◽  
Christine Norra ◽  
Winfried Randerath ◽  
Ole-Alexander Breithardt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Sleep Quality ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy

Abstract 3072: Beneficial Effects of Cardiac Resynchronization Therapy in Patients with Class Two Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kristin E Ellison ◽  
Brad J Mikaelian ◽  
Karin F Hoth ◽  
Fausto G Devecchi ◽  
Athena Poppas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Significant Difference ◽  
Minute Walk

Cardiac resynchronization therapy (CRT) improves heart failure (HF) symptoms in patients (pts) with EF <35%, QRS >120ms, and NYHA class 3 and 4 HF. The aim of this study was to compare the effects of CRT in pts with EF <35%, QRS >130, and class 2 vs 3/4 HF. We enrolled 25 patients. All received ECGs, transthoracic echocardiograms, 6 minute walk tests, and Minnesota quality of life questionnaires pre-op and three months post-op. Fourteen pts were class 2, 10 patients were class 3, and 1 class 4. Ischemic cardiomyopathy accounted for 7 out of the 14 class 2 pts and 5 out of the 11 class 3/4 pts. As a group, all patients had a significant increase in 6 minute walk (1150 vs 1249, p=0.02), increase in EF (30% vs 39%, p<0.01), decreased QRS duration (162 vs 143, p=0.001), and improved quality of life scores (31.1 vs 21.7, p=0.03), comparing pre and post-op measurements. There was no significant difference in response of class 2 versus class 3/4 pts (see table ). Nonischemic pts had greater response than ischemic pts. Class 2 HF pts reported greater improvement in mental health than class 3 and 4. Younger patients reported greater functional improvement, while pts with higher BMI reported less physical benefit. Summary: Pts with NYHA class 2 symptoms derive similar hemodynamic benefit from CRT as pts with class 3/4 symptoms and may derive greater mental health benefits than class 3/4 pts. Comparison of Pre and Post-Implant Parameters Between Class 2 and 3/4 Patients

Optimization in cardiac resynchronization therapy with quadripolar leads offer improvement in cardiac energetics in heart failure patients compared with bipolar leads: HUMVEE Clinical Trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Antoniou ◽  
C Chrysohoou ◽  
P Dilaveris ◽  
K Konstantinou ◽  
P Manolakou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Biventricular Pacing ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Power

Abstract Background Cardiac resynchronization therapy (CRT) is a well-established technique for symptomatic heart failure (HF) patients, producing significant clinical benefits. Recent studies have revealed the potential role of multipoint pacing (MPP) in improving response and clinical outcomes. The aim of this work from the Heart failUre study of Multisite pacing effects on VEntriculoartErial coupling (HUMVEE) trial was to evaluate the association between MPP of the left ventricle vs those of optimized biventricular pacing (optBVP) on: a) ventriculoarterial coupling (VAC) and energy efficiency of the failing heart. Both BVP and MPP mode were optimized according to the optimal VTI value of left ventricular outflow track. Methods HUMVEE is a single-center, prospective (13 months) trial (clinicaltrials.gov identifier NCT03189368), of 80 NYHA III patients (68±10 years; 75% men; 53% ischemic cardiomyopathy), under optimal tolerated therapy, with standard BVP indication, having being implanted with a CRT system able to deliver both modes of pacing. Echocardiographic measurements, including VAC calculation, 6-min-walking-test and quality of life (MLHF questionnaire) were measured at baseline, 6 months post BVP optimization (right before MPP activation) and at the end of follow-up (6 months post MPP optimization). Cardiac power (CP) was calculated according the equation: CP=Cardiac Output x Mean Aortic Pressure/451. Results 23 patients (30%), due to inability to deliver MPP, remained in optBVP. Those in MPP had 45% ischemic cardiomyopathy vs. 65% in optBVP patients, (p=0.056); ejection fraction 26.5%, vs. 29.5%, p=0.05; while there was no significant difference in gender, age and baseline NYHA class. Both optBVP and MPP patients improved VAC (baseline: 1,26±0,3; CRT: 1.18±0.4; MPP: 1.07±0.06, p=0.07); but only MPP patients significant improved from baseline to 12-months (p=0.02); CP was improved in both groups (p=0.02 in optBVD and p=0.01 in MPP), with MPP patients showing improvement in CP by 30% vs 12% in optBVP (p=0.001); 6-min-walk test was improved in MPP patients by 42% from baseline (p=0.0001), compared to optBVP patients who showed improvement up to 30% (p=0.05) and during the first 6 months only. NtproBNP levels were decreased in all patients (p=0.05 for MPP and p=0.07 for optBVP). Only patients who achieved MPP showed improvement in the Quality of life score (baseline: 31.6±23; optBVD:20.1±17; MPP:15.8±12, p=0.002; while those remained in optBVP showed no significant improvement. Conclusions MPP is a new, promising biventricular pacing modality offering additive effects on myocardial energy balance, cardiac power, systolic and diastolic ventricular function and aortoventricular coupling. HUMVEE trial illustrates those clinical, imaging and biochemical divergences of MPP from even opt BVP that confer significant improvement in quality of life reflecting better myocardial energy handling in patients with advanced HF and cardiac dysychronization. Funding Acknowledgement Type of funding source: None

P4529Atrioventricular optimization in cardiac resynchronization therapy with quadripolarleads, improves energy handling and quality of life in heart failure patients: HUMVEE Trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C K Antoniou ◽  
K Konstantinou ◽  
C Chrysohoou ◽  
P Dilaveris ◽  
N Magkas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Left Ventricle ◽  
Cardiac Resynchronization Therapy ◽  
Diastolic Function ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Resynchronization Therapy ◽  
Cardiac Power

Abstract Background Cardiac resynchronization therapy (CRT) is a well-established technique for symptomatic heart failure (HF) patients, producing significant clinical benefits. Recent studies have revealed the potential role of multipoint pacing (MPP) in improving response and clinical outcomes. The aim of Heart failUre study of Multisite pacing effects on VEntriculoartErial coupling (HUMVEE) trial was to evaluate the association between MPP of the left ventricle vs those of standard biventricular pacing (BVP) on: a) ventriculoarterial coupling (VAC) and energy efficiency of the failing heart, b) diastolic function, c) quality of life, and d) NT-proBNP levels. Methods HUMVEE is a single-center, prospective (13 months) trial (clinicaltrials.gov identifier NCT03189368), of 54 NYHA III patients (69±9 years; 79% men; 50% dilated cardiomyopathy), under optimal tolerated medical therapy, with standard BVP indication, having being implanted with a CRT system able to deliver both modes of pacing. Creatinine and NT-proBNP levels and echocardiographic measurements (VAC calculation, strain rate, diastolic function assessment), as well as 6-min-walking-test and quality of life (MLHF questionnaire) were measured at baseline, 6 months post BVP optimization (right before MPP activation) and at the end of follow-up (6 months post MPP optimization). Cardiac power (CP) was calculated according the equation: CP=Cardiac Output x Mean Aortic Pressure/451. Results Both CRT and MPP improved 6-min-walk (differences at baseline/6 mo/end of FU: 277±27 vs. 345±27 vs 363±27 m, p=0.07); left ventricular ejection fraction (24,2% vs 30,6%vs, 32%, p=0.05); end -diastolic diameters of left ventricle (65±1,4 vs. 63±1.7 vs. 61±1.1, p=0.03); end-systolic volume (150±15 vs. 140±10 vs. 131±13, p=0.08); stroke volume (41.6±9 vs. 53.6±14 vs. 62±9, p=0.0001 for MPP); left atrial volume (76±5 vs. 74±10 vs 61±6, p=0.001 for MPP), E/Emv (14±5 vs. 12±4 vs. 11±3, p=0.05 for MPP); NtproBNP (2782±1000 vs. 2080±2500 vs. 2000±1000, p=0.05 for MPP). VAC was reduced from 1.14±0.27 to 1.1±0.17 (p=0.1) while CP increased from 564.2±142 to 768±103 (p=0.009). Quality of life score (the lower the better) improved from 23.75±17 at baseline to 17.25±10 at end of FU (p=0.05). Conclusions MPP is a new, promising pacing modality with the potential to improve HF patients' outcome, offering additive effects on myocardial energy balance, cardiac power, systolic and diastolic ventricular function and aortoventricular coupling, especially in ischemic patients. HUMVEE trial illustrates those clinical, imaging and biochemical divergences of MPP from standard BVP that reflect significant improvement in quality of life in patients with advanced HF and cardiac dysychronization.

scholarly journals Сhanges in quality of life in patients with congestive heart failure after cardiac resynchronization therapy

Kardiologiia ◽  
2019 ◽  
Vol 59 (11S) ◽  
pp. 36-43
Author(s):  
G. S. Pushkarev ◽  
V. A. Kuznetsov ◽  
Ya. A. Fisher ◽  
A. D. Sapozhnikova ◽  
A. M. Soldatova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Physical Functioning ◽  
Bodily Pain ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
One Year

Purpose. To assess the quality of life (QoL) changes in patients with congestive heart failure (CHF) one year after cardiac resynchronization therapy (CRT). Methods. The study included 82 patients (68 males and 14 females) aged from 30 to 74 (mean age 55.8±9.2 years) who underwent implantation of a biventricular cardiac pacemaker for CRT. Depending on the echocardiographic response to CPT, the patients were divided into two groups: 56 people with a positive response (responders) and 26 people with insufficient response (non-responders). The SF-36 questionnaire was used to measure QoL. The results of the questionnaire were represented as scores over the eight subscales: physical functioning (PF), role-physical functioning (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), and mental health perceptions (MH). The QoL assessment was performed before and one year after CRT. Results. Patients with CHF one year following CRT had significantly higher rates of improvement in PF QoL (before CRT 46.28±26.16; one year after CRT 53.05±27.65, p=0.023). The statistical tendency towards QoL improvement was revealed: VT QoL (before CRT 47.07±20.12, after CRT 51.83±20.07, p=0.081), SF (before СРТ 61.58±25.06, after CRT 67.07±24.57, p=0.088). Group of responders one year after CRT had significantly higher rates of improvement of QoL in PF (45.2±26.0 before CRT vs 57.1±26.4 after CRT, p=0.001); in VT (46.5±20.8 vs 54.4±19.7, p=0.010) and in SF (60.9±26.4 vs 70.8±20.8, p=0.012). The statistical tendency towards QoL improvement was revealed in BP (57.5±25.1 before CRT vs 64.8±23.8 after CRT, p=0.079), in GH (45.3±16.4 vs 49.1±18.0, p=0.079) and in MH (57.7±18.9 vs 62.5±17.7, p=0.081). In the group of nonresponders the statistical tendency towards decrease in QoL was detected during one year after CRT in RE (46.2±45.3 before CRT vs 26.9±41.1 after CRT, p=0.07). No significant differences were found in paired comparisons of other QoL indicators. Conclusion. We revealed significant increase in PF index in patients with CHF one year following CRT. The study showed that QoL was generally improving one year following CRT in responders while a tendency towards decrease in RE was detected in non-responders. 

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