Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy
| Autor: | Dylan Eiger, Daniel P. Fishbein, Zainab Samad, Jeanne E. Poole, Kerry L. Lee, Daniel Friedman, Sana M. Al-Khatib, Gillian D Sanders, Daniel B. Mark, Qijun Li, Lurdes Y. T. Inoue, Gust H. Bardy |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Cardiomyopathy Placebo Ventricular Function Left Sudden cardiac death QRS complex Risk Factors Internal medicine Humans Medicine In patient cardiovascular diseases Heart Failure Ejection fraction business.industry Stroke Volume General Medicine medicine.disease Implantable cardioverter-defibrillator humanities Defibrillators Implantable Death Sudden Cardiac Heart failure cardiovascular system Cardiology Female Cardiomyopathies Cardiology and Cardiovascular Medicine business therapeutics circulatory and respiratory physiology |
| Zdroj: | Cardiology Journal. 29:978-984 |
| ISSN: | 1898-018X 1897-5593 |
| DOI: | 10.5603/cj.a2020.0187 |
| Popis: | Background: Many patients in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) had a significant improvement (> 10%) in the left ventricular ejection fraction (LVEF) during the course of the study, but the factors and outcomes associated with such improvement are uncertain. Methods: We examined factors and rates of mortality, cause-specific mortality, and implantable cardioverter defibrillator (ICD) shocks associated with improvement in LVEF by analyzing patients in the SCD-HeFT who were randomized to placebo or an ICD and who had an LVEF checked during follow-up. Results: During a median follow-up of 3.99 years, of 837 patients who had at least two follow-up LVEF measurements, 276 (33%) patients had > 10% improvement in LVEF and 561 (67%) patients had no significant change in LVEF. Factors significantly associated with LVEF improvement included female sex, white race, history of hypertension, a QRS duration < 120 ms, and beta-blocker use. Improvement in LVEF was associated with a significant improvement in survival. There was no significant association between improvement in LVEF and cause-specific death, but there was a significant association between improvement in LVEF and reduced risk of receiving appropriate ICD shocks. Conclusions: About a third of patients in this analysis, who were randomized to placebo or an ICD in SCD-HeFT, had a significant improvement in LVEF during follow-up; improvement in LVEF was associated with improved survival but not with cause-specific death, and with decreased likelihood of receiving appropriate ICD shocks. |
| Databáze: | OpenAIRE |
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