Russian Heart Failure Journal 2010year Long term results of cardiac resynchronization therapy on survival of patients with chronic heart failure and low left ventricular ejection fraction


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2010/

Long term results of cardiac resynchronization therapy on survival of patients with chronic heart failure and low left ventricular ejection fraction

Kuznetsov V. A., Churkevich T. O., Kolunin G. V., Harats V. E., Pavlov A. V., Krinochkin D. V., Gorbatenko E. A., Gorbunova T. Y., Rychkov A. Y.

Keywords: survival of patients, resynchronization therapy, ejection fraction, CHF

DOI: 10.18087/rhfj.2010.4.1346

Background. Cardiac resynchronization therapy (CRT) is quit new and relevant treatment for patients with moderate and severe CHF and low left ventricular ejection fraction (LVEF). Objective. To compare effects of SRT in combination with optimal drug therapy (ODT) in comparison with isolated ODT on survival of patients with CHF and low LVEF during long-term follow-up. Materials and methods. The study included 255 patients with CHF FC II–IV (NYHA) and LVEF ≤35 %: 99 patients with implanted devices for CRT and receiving ODT, and 156 patients just receiving ODT. Average follow-up was 26±17 months. Results. Kaplan-Meier method and Cox’s proportional hazard model revealed, that survival rate of patients treated with CRT + ODT was significantly higher (66.4 %), than in another group (57.9 %), p=0.007. Among all evaluated clinical and functional characteristics just treatment method had independent significant influence on risk of death, which was 2.35 (CI 1.01–5.46) in the group of ODT (it was higher by 135 % in comparison with CRT + OMT group, p=0.048). Thus, the combination of CRT and OMT provides higher survival rate of patients with CHF and low LVEF in comparison with conservative therapy during long-term follow-up.
  1. American Heart Association (2000), 2000 Heart and Stroke Statistical Update, Dallas, TX.
  2. Jessup M, Brozena S. Heart failure. N Engl J Med. 2003;348 (20):2007–2018.
  3. Ардашев А. В. Клиническая аритмология. – М.: МЕДПРАКТИКА-М, 2009. – 1220с.
  4. Агеев Ф. Т., Даниелян М. О., Мареев В. Ю., Беленков Ю. Н. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения (по материалам исследования ЭПОХА–О–ХСН). Журнал Сердечная Недостаточность. 2004;5 (1):4–7.
  5. Даниелян М. О. Прогноз и лечение хронической сердечной недостаточности (данные 20‑и летнего наблюдения) Автореф. Дисс. Канд. Мед. наук., Москва, 2001.
  6. Bristow M, Saxon L, Boehmer J et al. Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) Investigators. Cardiac – resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004 May 20;350 (21):2140–2150.
  7. Cleland JG, Daubert JC, Erdmann E et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352 (15):1539–1549.
  8. Abraham WT, Fisher WG, Smith AL et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002;346 (24):1845–1853.
  9. Митрофанова С. А., Соколов А. А., Антонченко И. В. и др. Предикторы эффективности сердечной ресинхронизирующей терапии. Журнал Вестник аритмологии. 2007;50:16–20.
  10. Колунин Г. В., Кузнецов В. А., Харац В. E. и др. Отдаленные результаты динамики хронической сердечной недостаточности у пациентов на фоне сердечной ресинхронизирующей терапии. Журнал Анналы аритмологии. 2009;3:40–53.
  11. Якоб О. В. Электрокардиостимуляция в коррекции хронической сердечной недостаточности: клинико-инструментальная оценка эффективности, качества жизни, стратификации осложнений и исходов по данным 5 летнего проспективного исследования: Автореф. дис. … док. мед. наук. – М., 2007. – 38с.
  12. Кузнецов В. А., Колунин Г. В., Харац В. Е. и др. Эффект сердечной ресинхронизирующей терапии в лечении хронической сердечной недостаточности. Кардиология. 2005;45 (9):29–31.
  13. Кузнецов В. А. Сердечная ресинхронизирующая терапия: избранные вопросы. – М.: Абис, 2007. – 128с.
  14. Kronborg M. B., Mortensen P. T., Kirkfeldt R. E. et al. Very long term follow-up of cardiac resynchronization therapy: Clinical outcome and predictors of mortality. Heart Failure. 2008;10 (8):796–801.
  15. Khadjooi K, Foley PW, Chalil S et al. Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation. Heart. 2008;94 (7):879–883.
  16. Cleland JG, Daubert JC, Erdmann E et al. Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase]. Eur Heart J. 2006;27 (16):1928–1932.
  17. Abraham WT, Young J, Smith AL et al., for InSync Registry Investigators. Comparison of all-cause mortality in a randomized controlled trial (MIRACLE) and «Real-World» (InSync Registry) Use of cardiac resynchronization therapy (CRT). Cardiac failure. 2007;13 (6):126.
Kuznetsov V. A., Churkevich T. O., Kolunin G. V. et al. Long term results of cardiac resynchronization therapy on survival of patients with chronic heart failure and low left ventricular ejection fraction. Russian Heart Failure Journal. 2010;11(4):203-205.

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