Matching Imaging and Remodulation Effects: Benefits of Cardiac Contractility Modulation Shown by Global Longitudinal...

Area of Science:

• Cardiology
• Biomedical Engineering

Background:

• Heart failure with reduced ejection fraction (HFrEF) significantly impacts patient quality of life and leads to frequent hospitalizations.
• Percutaneous coronary intervention (PCI) is a standard treatment for acute coronary syndrome.
• Cardiac Contractility Modulation (CCM) is an emerging therapy for HFrEF patients experiencing recurrent symptoms.

Observation:

• A patient with HFrEF, following PCI for non-ST-elevation acute coronary syndrome and best medical therapy for decompensated heart failure, refused an implantable cardioverter-defibrillator (ICD).
• To mitigate recurrent heart failure (HF) exacerbations and hospitalizations, a CCM device was implanted.
• The patient exhibited significant improvements in exercise capacity and quality of life.

Findings:

• Post-CCM implantation, the patient showed marked improvements in the six-minute walk test (SMWT) and Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores.
• Echocardiographic parameters, including global longitudinal strain (GLS) measured by speckle tracking imaging, improved, indicating positive myocardial remodeling.
• No HF-related hospital admissions were recorded up to 9 months post-discharge.

Implications:

• CCM presents a viable therapeutic option for HFrEF patients, particularly those who decline or are unsuitable for ICDs.
• The study highlights the potential of CCM to enhance functional capacity, improve quality of life, and reduce healthcare utilization in HFrEF.
• Speckle tracking imaging demonstrates a correlation between CCM therapy, improved GLS, and beneficial myocardial remodeling effects.