Abstract:
OBJECTIVES:We sought to determine the effects of cardiac resynchronization therapy (CRT) in New York Heart Association (NYHA) functional class II heart failure (HF) and NYHA functional class I (American College of Cardiology/American Heart Association stage C) patients with previous HF symptoms. BACKGROUND:Cardiac resynchronization therapy improves left ventricular (LV) structure and function and clinical outcomes in NYHA functional class III and IV HF with prolonged QRS. METHODS:Six hundred ten patients with NYHA functional class I or II heart failure with a QRS > or =120 ms and a LV ejection fraction < or =40% received a CRT device (+/-defibrillator) and were randomly assigned to active CRT (CRT-ON; n = 419) or control (CRT-OFF; n = 191) for 12 months. The primary end point was the HF clinical composite response, which scores patients as improved, unchanged, or worsened. The prospectively powered secondary end point was LV end-systolic volume index. Hospitalization for worsening HF was evaluated in a prospective secondary analysis of health care use. RESULTS:The HF clinical composite response end point, which compared only the percent worsened, indicated 16% worsened in CRT-ON compared with 21% in CRT-OFF (p = 0.10). Patients assigned to CRT-ON experienced a greater improvement in LV end-systolic volume index (-18.4 +/- 29.5 ml/m2 vs. -1.3 +/- 23.4 ml/m2, p < 0.0001) and other measures of LV remodeling. Time-to-first HF hospitalization was significantly delayed in CRT-ON (hazard ratio: 0.47, p = 0.03). CONCLUSIONS:The REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) trial demonstrates that CRT, in combination with optimal medical therapy (+/-defibrillator), reduces the risk for heart failure hospitalization and improves ventricular structure and function in NYHA functional class II and NYHA functional class I (American College of Cardiology/American Heart Association stage C) patients with previous HF symptoms. (REsynchronization reVErses Remodeling in Systolic Left vEntricular Dysfunction [REVERSE]; NCT00271154).
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Linde C,Abraham WT,Gold MR,St John Sutton M,Ghio S,Daubert C,REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) Study Group.doi
10.1016/j.jacc.2008.08.027subject
Has Abstractpub_date
2008-12-02 00:00:00pages
1834-1843issue
23eissn
0735-1097issn
1558-3597pii
S0735-1097(08)02913-6journal_volume
52pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVES:This study was designed to determine whether coronary vasospasm in patients with variant angina pectoris (VAP) may produce focal organic lesions at the site of vasospasm that would contribute to disease progression. BACKGROUND:Recent clinical angiographic and experimental studies have demonstrated the poten...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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abstract:OBJECTIVES:The goal of this study was to determine the magnitude and mechanisms of hemodynamic improvement of an automated, load-distributing band device (AutoPulse, Revivant Corp., Sunnyvale, California) compared with conventional cardiopulmonary resuscitation (C-CPR). BACKGROUND:Improved blood flow during cardiopulm...
journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:It was the purpose of this study to define the electrophysiologic (EP) identity of left septal atrial tachycardia (AT). BACKGROUND:The clinical and EP characteristics of this particular type of arrhythmia have not been fully described. METHODS:A total of 120 patients with AT underwent invasive EP evaluatio...
journal_title:Journal of the American College of Cardiology
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更新日期:2002-09-18 00:00:00
abstract::The mechanism of the antianginal actions of nilvadipine was investigated in 11 patients with effort angina pectoris. Hemodynamic data were obtained by angina-limited supine multistage bicycle ergometer exercise testing before and after a single 6 mg dose of nilvadipine. Compared with chest pain during control exercise...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(87)80277-2
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abstract::Although clinical trials using laser and thermal angioplasty devices have been underway, the effects of pulsed laser and thermal ablation of atherosclerotic plaque on surface thrombogenicity are poorly understood. This study examined the changes in platelet adherence and thrombus formation on freshly harvested atheros...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90301-3
更新日期:1992-04-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1996-01-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2000-11-15 00:00:00
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更新日期:2001-11-01 00:00:00
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更新日期:1994-03-01 00:00:00
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更新日期:2002-08-21 00:00:00
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更新日期:2005-05-17 00:00:00
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更新日期:2004-01-07 00:00:00
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pub_type: 杂志文章
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更新日期:1989-07-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2015-06-23 00:00:00