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Biventricular versus left ventricular only stimulation: an echocardiographic substudy of the B-LEFT HF trial.
Ansalone, Gerardo; Boriani, Giuseppe; Sassone, Biagio; Camastra, Giovanni; Donal, Erwan; Calò, Leonardo; Casella, Michela; Delarche, Nicolas; Lozano, Ignacio Fernandez; Biffi, Mauro; Boulogne, Eric; Guidotto, Tiziana; Leclercq, Christophe.
Afiliação
  • Ansalone G; Ospedale Madre Giuseppina Vannini, Rome.
  • Boriani G; Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena.
  • Sassone B; Department of Cardiology, Ospedale SS.ma Annunziata, Azienda Unità Sanitaria Locale Ferrara, Cento, Italy.
  • Camastra G; Ospedale Madre Giuseppina Vannini, Rome.
  • Donal E; CHU Pontchaillou, Rennes, France.
  • Calò L; Policlinico Casilino, Rome.
  • Casella M; Heart Rhythm Center, Centro Cardiologico Monzino, Milan, Italy.
  • Delarche N; CH Président F. Mitterand, Pau, France.
  • Lozano IF; Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Biffi M; Institute of Cardiology, University of Bologna, Azienda Ospedaliera S.Orsola-Malpighi, Bologna, Italy.
  • Boulogne E; St Jude Medical, Zaventem, Belgium.
  • Guidotto T; St Jude Medical, Milan, Italy.
  • Leclercq C; CHU Pontchaillou, Rennes, France.
J Cardiovasc Med (Hagerstown) ; 24(7): 453-460, 2023 07 01.
Article em En | MEDLINE | ID: mdl-37285276
BACKGROUND: The noninferiority of left ventricular pacing alone (LVp) compared with biventricular pacing (BIV) has not been yet definitely documented. In this study, we reviewed all the original echocardiographic measures of the Biventricular versus Left Univentricular Pacing with ICD Back-up in Heart Failure Patients (B-LEFT HF) trial in order to investigate mechanisms underlying LV remodelling with both pacing modalities. METHODS: Patients with New York Heart Association functional class (NYHA) III or IV despite optimal medical therapy, LVEF 35% or less, left ventricular end-diastolic diameter (LVEDD) more than 55 mm, QRS duration at least 130 ms were randomized to BIV or LVp for 6 months. The primary end point was a composite of at least 1 point decrease in NYHA class and at least 5 mm decrease in left ventricular end-systolic diameter (LVESD). An additional end point was a LVp reverse remodelling defined as at least 10% decrease in LVESD. Mitral regurgitation and all echocardiographic measures were reassessed after 6-month follow-up. RESULTS: One hundred and forty-three patients were enrolled. Seventy-six patients were in the BIV and 67 were in the LVp group. Left ventricular volumes decreased significantly without difference between groups (P = 0.8447). Similarly, left ventricular diameters decreased significantly in both groups with a significant decrease in LVESD with BIV (P < 0.0001), but not with LVp (P = 0.1383). LVEF improved in both groups without difference (P = 0.8072). Mitral regurgitation did not improve either with BIV, or with LVp. CONCLUSION: The echocardiographic sub-analysis of B-LEFT study showed the substantial equivalence of LVp in favouring left ventricular reverse remodelling as compared with BIV.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Terapia de Ressincronização Cardíaca / Insuficiência Cardíaca / Insuficiência da Valva Mitral Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Terapia de Ressincronização Cardíaca / Insuficiência Cardíaca / Insuficiência da Valva Mitral Idioma: En Ano de publicação: 2023 Tipo de documento: Article