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Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy
, 2, 2, 3, 14, 5, 16, 1, 1, 5, 16, 16
Affiliations- Department of Medicine, Duke University, Durham, NC, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- The Seattle Institute for Cardiac Research, Seattle, WA, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
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Abstract
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.
Abstract
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.
Keywords
defibrillator, implantable, heart failure, sudden cardiac death, arrhythmia
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About this articleTitle
Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy
Journal
Issue
Article type
Original Article
Pages
978-984
Published online
2020-12-31
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4510
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843
DOI
Pubmed
Bibliographic record
Cardiol J 2022;29(6):978-984.
Keywords
defibrillator
implantable
heart failure
sudden cardiac death
arrhythmia
Authors
Dylan S. Eiger
Lurdes Y.T. Inoue
Qijun Li
Gust Bardy
Kerry Lee
Jeanne Poole
Daniel Mark
Zainab Samad
Daniel Friedman
Daniel Fishbein
Gillian Sanders
Sana M. Al-Khatib
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