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Published online: 2020-12-31
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Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy

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
DOI: 10.5603/CJ.a2020.0187
·
Pubmed: 33438181

open access

Ahead of print
Original articles
Published online: 2020-12-31

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.

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Keywords

defibrillator, implantable, heart failure, sudden cardiac death, arrhythmia

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About this article
Title

Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2020-12-31

DOI

10.5603/CJ.a2020.0187

Pubmed

33438181

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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