Time to left ventricular reverse remodeling after cardiac resynchronization therapy: Better late than never

Area of Science:

• Cardiology
• Heart Failure Management
• Medical Device Therapy

Background:

• Left ventricular reverse remodeling (LVRR) is a key outcome of cardiac resynchronization therapy (CRT).
• The timing and predictors of LVRR remain incompletely understood.
• Previous studies suggest LVRR typically occurs within 6 months of CRT.

Purpose of the Study:

• To investigate the long-term echocardiographic and clinical outcomes of patients experiencing LVRR more than 6 months after CRT.
• To identify predictors associated with delayed LVRR response.

Main Methods:

• A cohort of 127 patients receiving CRT was categorized into three groups: late LVRR (>6 months), early LVRR (<6 months), and no LVRR.
• Clinical and echocardiographic data were analyzed to compare outcomes and identify predictors.

Main Results:

• Late LVRR occurred in 15% of patients, who were older, more likely to have ischemic heart disease, and had higher NYHA class.
• Late LVRR patients showed intermediate clinical response rates and higher hospital readmissions for heart failure compared to early LVRR.
• Ischemic etiology and NYHA functional class

Conclusions:

• Late LVRR, while associated with better outcomes than no LVRR, demonstrates a less optimal response compared to early LVRR.
• Identifying predictors like ischemic etiology and NYHA class is crucial for managing delayed CRT response.