scholarly journals P1691Enlarged left atrium is an independent risk factor for long-term mortality in heart failure patients with reduced ejection fraction and received implantable cardioverter defibrillators

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
K. Hu ◽  
D. Liu ◽  
L. Sych ◽  
L. Knackstedt ◽  
G. Ertl ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Factor ◽  
Ejection Fraction ◽  
Independent Risk Factor ◽  
Implantable Cardioverter Defibrillators ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Cardioverter Defibrillators ◽  
Long Term Mortality

scholarly journals Implantable cardioverter‐defibrillators in heart failure patients with reduced ejection fraction and diabetes

2018 ◽  
Vol 20 (6) ◽  
pp. 1031-1038 ◽  
Author(s):  
Abhinav Sharma ◽  
Sana M. Al‐Khatib ◽  
Justin A. Ezekowitz ◽  
Lauren B. Cooper ◽  
Christopher B. Fordyce ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Implantable Cardioverter Defibrillators ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Cardioverter Defibrillators

scholarly journals Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy in the Treatment of Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 10 ◽  
Author(s):  
Ilaria Spoletini ◽  
Andrew Coats
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
Device Therapy ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Cardioverter Defibrillators

It has been long acknowledged that electrical-conduction disturbances may be both a cause of heart failure and a consequence of it. In fact, many patients with heart failure have an asynchronous contraction pattern of the heart muscle that further reduces the heart ability to pump blood. Electrical disturbances may therefore result in progressive left ventricular dysfunction, due to the added effects of HF-related electrical dyssynchrony. For this reason, device therapy may play a key role in the management of patients with heart failure and reduced ejection fraction (HFrEF). In particular, Implantable Cardioverter- Defibrillators (ICD) and Cardiac Resynchronization Therapy (CRT) may improve ejection fraction by reestablishing mechanical synchrony, possibly reversing symptoms and signs of heart failure, in addition to the more obvious role of ICD in terminating ventricular arrhythmias that threaten sudden death. Recommendations on device therapy from the current guidelines on heart failure management put out by the ESC/HFA in 2016 update our understanding of the evidence base for the use of ICD and CRT in HFrEF. We review these recommendations and the evidence behind them.

Abstract 5582: Impact of a Concurrent Chronic Total Occlusion on Long-term Mortality in Hospital Survivors after ST Elevation Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Bimmer E Claessen ◽  
Rene J van der Schaaf ◽  
Karel T Koch ◽  
jan Baan ◽  
Jan G Tijssen ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Ejection Fraction ◽  
Chronic Total Occlusion ◽  
Independent Risk Factor ◽  
Left Ventricular Ejection ◽  
Primary Pci ◽  
Total Occlusion ◽  
Long Term Mortality

Background: Patients with multivessel disease (MVD) constitute a patient group with a high risk of mortality after STEMI. Recently, it was reported that the higher mortality in patients with MVD is determined by the presence of a chronic total occlusion (CTO) in a noninfarct-related artery. Due to the higher risk profile, the in-hospital mortality rate accounted for this unfavorable outcome, moreover, multivariate analysis did not correct for residual left ventricular ejection fraction (LVEF). Therefore, we studied the effect of a concurrent CTO on long-term mortality, excluding deaths in the first 30 days and correcting for LVEF. Methods: Between 1997 and 2005, we admitted 3309 patients with STEMI treated with primary PCI. We categorized patients as having single vessel disease (SVD), MVD without CTO and CTO based on the angiogram before PCI. LVEF was assessed with echocardiography by global assessment of ejection fraction within 30 days after primary PCI and classified as ≤40% or >40%. Stepwise Cox regression was used for multivariate analysis. Results: LVEF data were available for 1538 patients, of which 1485 (97%) survived the first 30 days after STEMI. SVD was present in 1013 patients (68%), MVD without CTO in 325 patients (22%) and a concurrent CTO in 147 patients (10%). Median duration of follow-up was 3.5 years (IQR 2.1–5.2 years). A total of 104 patients (7.0%) died; 61 (6.0%) in the SVD group, 25 (7.7%) in the MVD group and 18 (12%) in the CTO group (p=0.02). Median time to death was 2.1 years. After correction for the presence of MVD without CTO and differences in baseline variables (age>60 years, residual LVEF ≤40%, diabetes, hypercholesterolemia, smoking, previous MI and shock) the presence of a CTO in a noninfarct-related artery is an independent risk factor for death (Hazard ratio (HR) 1.7, 95% CI 1.0 –2.8, p=0.04). Other independent risk factors are age >60 years (HR 3.0, 95% CI 2.0 – 4.7, p<0.01) and residual LVEF ≤40% (HR 2.3, 95%CI 1.5–3.4, p<0.01) Conclusion: After primary PCI, the presence of a CTO in a noninfarct-related vessel, and not the mere presence of MVD, is a strong and independent risk factor for long-term mortality even when adjusted for residual LVEF ≤40% and excluding deaths in the first 30 days.

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