Efficacy and survival in patients with cardiac contractility modulation: long-term single center experience in 81 patients
To analyze long-term efficacy and survival in patients with chronic heart failure treated with cardiac contractility modulation. 81 patients implanted with a CCM device between 2004 and 2012 were included in this retrospective analysis. Changes in NYHA class, ejection fraction (EF), Minnesota Living...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
20 January 2015
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| In: |
International journal of cardiology
Year: 2015, Volume: 183, Pages: 76-81 |
| ISSN: | 1874-1754 |
| DOI: | 10.1016/j.ijcard.2014.12.178 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.ijcard.2014.12.178 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0167527315000583 
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| Author Notes: | Jürgen Kuschyk, Susanne Roeger, Raphaela Schneider, Florian Streitner, Ksenija Stach, Boris Rudic, Christel Weiß, Rainer Schimpf, Theano Papavasilliu, Benny Rousso, Daniel Burkhoff, Martin Borggrefe |
| Summary: | To analyze long-term efficacy and survival in patients with chronic heart failure treated with cardiac contractility modulation. 81 patients implanted with a CCM device between 2004 and 2012 were included in this retrospective analysis. Changes in NYHA class, ejection fraction (EF), Minnesota Living with Heart Failure Questionnaire, NT-proBNP and peak VO2 were analyzed during a mean follow up of 34.2±28months (6-123months). Observed mortality rate was compared with that predicted by the MAGGIC Score. Patients were 61±12years old with EF 23±7%. Heart failure was due to ischemic (n=48, 59.3%) or idiopathic dilated (n=33, 40.7%) cardiomyopathy. EF increased from 23.1±7.9 to 29.4±8.6% (p<0.05), mean NT-proBNP decreased from 4395±3818 to 2762±3490ng/l (p<0.05) and mean peak VO2 increased from 13.9±3.3 to 14.6±3.5ml/kg/min (p=0.1). The overall clinical responder rate (at least 1 class improvement of NYHA within 6months or last follow-up) was 74.1%. 21 (25.9%) patients died during follow up, 11 (52.4%) due to cardiac conditions and 10 (47.6%) due to non-cardiac conditions. Mortality rates at 1 and 3years were 5.2% and 29.5% compared to mortality rates estimated from the MAGGIC risk score of 18.4% (p<0.001) and 40% (p=ns), respectively. Log-Rank analysis of all events through 3years of follow-up, however, was significantly less than predicted (p=0.022). CCM therapy improved quality of life, exercise capacity, NYHA class, EF and NT-proBNP levels during long-term follow up. Mortality rates appeared to be lower than estimated from the MAGGIC score. |
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| Item Description: | Gesehen am 29.08.2017 |
| Physical Description: | Online Resource |
| ISSN: | 1874-1754 |
| DOI: | 10.1016/j.ijcard.2014.12.178 |