医学
射血分数
心脏病学
内科学
心力衰竭
收缩性
缺血性心肌病
QRS波群
心肌病
扩张型心肌病
作者
Christian Fastner,Goekhan Yuecel,Boris Rudic,Gereon Schmiel,Matthias Toepel,Daniel Burkhoff,Volker Liebe,Mathieu Kruska,Svetlana Hetjens,Martin Borggrefe,İbrahim Akın,Juergen Kuschyk
标识
DOI:10.1016/j.ijcard.2021.07.048
摘要
Cardiac contractility modulation (CCM) is an FDA-approved device-based therapy for patients with systolic heart failure and normal QRS width who are symptomatic despite optimal drug therapy. The purpose of this study was to compare the long-term therapeutic effects of CCM therapy in patients with ischemic (ICM) versus non-ischemic cardiomyopathy (NICM).Changes in NYHA class, KDIGO CKD stage, left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE), and NT-proBNP levels were compared as functional parameters. Moreover, observed mortality rates at 1 and 3 years were compared to those predicted by the MAGGIC heart failure risk score, and observed mortality rates were compared between groups for the entire follow-up period.One hundred and seventy-four consecutive patients with chronic heart failure and CCM device implantation between 2002 and 2019 were included in this retrospective analysis. LVEF was significantly higher in NICM patients after 3 years of CCM therapy (35 ± 9 vs. 30 ± 9%; p = 0.0211), and after 5 years, also TAPSE of NICM patients was significantly higher (21 ± 5 vs. 18 ± 5%; p = 0.0437). There were no differences in other effectiveness parameters. Over the entire follow-up period, 35% of all patients died (p = 0.81); only in ICM patients, mortality was lower than predicted at 3 years (35 vs. 43%, p = 0.0395).Regarding improvement of biventricular systolic function, patients with NICM appear to benefit particularly from CCM therapy.
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