AustralieFrV1, Main, Exploration, bibRecord, 005061

Cardiac-Resynchronization Therapy in Heart Failure with a Narrow QRS Complex

Identifieur interne : 005061 ( Main/Exploration ); précédent : 005060; suivant : 005062

Cardiac-Resynchronization Therapy in Heart Failure with a Narrow QRS Complex

Auteurs : Frank Ruschitzka [Suisse] ; William T. Abraham [États-Unis] ; Jagmeet P. Singh [États-Unis] ; Jeroen J. Bax [Pays-Bas] ; Jeffrey S. Borer [États-Unis] ; Josep Brugada [Espagne] ; Kenneth Dickstein [Norvège] ; Ian Ford [Royaume-Uni] ; John Iii Gorcsan [États-Unis] ; Daniel Gras [France] ; Henry Krum [Australie] ; Peter Sogaard [Danemark] ; Johannes Holzmeister [Suisse]

Source :

The New England journal of medicine [ 0028-4793 ] ; 2013.

RBID : Pascal:13-0314576

Descripteurs français

Pascal (Inist)
- Insuffisance cardiaque, Traitement instrumental, Médecine, Resynchronisation cardiaque.
Wicri :
- topic : Médecine.

English descriptors

KwdEn :
- Cardiac resynchronization, Heart failure, Instrumentation therapy, Medicine.

Abstract

BACKGROUND Cardiac-resynchronization therapy (CRT) reduces morbidity and mortality in chronic systolic heart failure with a wide QRS complex. Mechanical dyssynchrony also occurs in patients with a narrow QRS complex, which suggests the potential usefulness of CRT in such patients. METHODS We conducted a randomized trial involving 115 centers to evaluate the effect of CRT in patients with New York Heart Association class III or IV heart failure, a left ventricular ejection fraction of 35% or less, a QRS duration of less than 130 msec, and echocardiographic evidence of left ventricular dyssynchrony. All patients underwent device implantation and were randomly assigned to have CRT capability turned on or off. The primary efficacy outcome was the composite of death from any cause or first hospitalization for worsening heart failure. RESULTS On March 13, 2013, the study was stopped for futility on the recommendation of the data and safety monitoring board. At study closure, the 809 patients who had undergone randomization had been followed for a mean of 19.4 months. The primary outcome occurred in 116 of 404 patients in the CRT group, as compared with 102 of 405 in the control group (28.7% vs. 25.2%; hazard ratio, 1.20; 95% confidence interval [CI], 0.92 to 1.57; P=0.15). There were 45 deaths in the CRT group and 26 in the control group (11.1% vs. 6.4%; hazard ratio, 1.81; 95% CI, 1.11 to 2.93; P=0.02). CONCLUSIONS In patients with systolic heart failure and a QRS duration of less than 130 msec, CRT does not reduce the rate of death or hospitalization for heart failure and may increase mortality.

Affiliations:

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Le document en format XML

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<author><name sortKey="Gorcsan, John Iii" sort="Gorcsan, John Iii" uniqKey="Gorcsan J" first="John Iii" last="Gorcsan">John Iii Gorcsan</name>
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<s3>AUS</s3>
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<author><name sortKey="Sogaard, Peter" sort="Sogaard, Peter" uniqKey="Sogaard P" first="Peter" last="Sogaard">Peter Sogaard</name>
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<placeName><settlement type="city">Aalborg</settlement>
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<orgName type="university">Université d'Aalborg</orgName>
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<author><name sortKey="Holzmeister, Johannes" sort="Holzmeister, Johannes" uniqKey="Holzmeister J" first="Johannes" last="Holzmeister">Johannes Holzmeister</name>
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<series><title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cardiac resynchronization</term>
<term>Heart failure</term>
<term>Instrumentation therapy</term>
<term>Medicine</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Insuffisance cardiaque</term>
<term>Traitement instrumental</term>
<term>Médecine</term>
<term>Resynchronisation cardiaque</term>
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<front><div type="abstract" xml:lang="en">BACKGROUND Cardiac-resynchronization therapy (CRT) reduces morbidity and mortality in chronic systolic heart failure with a wide QRS complex. Mechanical dyssynchrony also occurs in patients with a narrow QRS complex, which suggests the potential usefulness of CRT in such patients. METHODS We conducted a randomized trial involving 115 centers to evaluate the effect of CRT in patients with New York Heart Association class III or IV heart failure, a left ventricular ejection fraction of 35% or less, a QRS duration of less than 130 msec, and echocardiographic evidence of left ventricular dyssynchrony. All patients underwent device implantation and were randomly assigned to have CRT capability turned on or off. The primary efficacy outcome was the composite of death from any cause or first hospitalization for worsening heart failure. RESULTS On March 13, 2013, the study was stopped for futility on the recommendation of the data and safety monitoring board. At study closure, the 809 patients who had undergone randomization had been followed for a mean of 19.4 months. The primary outcome occurred in 116 of 404 patients in the CRT group, as compared with 102 of 405 in the control group (28.7% vs. 25.2%; hazard ratio, 1.20; 95% confidence interval [CI], 0.92 to 1.57; P=0.15). There were 45 deaths in the CRT group and 26 in the control group (11.1% vs. 6.4%; hazard ratio, 1.81; 95% CI, 1.11 to 2.93; P=0.02). CONCLUSIONS In patients with systolic heart failure and a QRS duration of less than 130 msec, CRT does not reduce the rate of death or hospitalization for heart failure and may increase mortality.</div>
</front>
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<li>Espagne</li>
<li>France</li>
<li>Norvège</li>
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<li>Royaume-Uni</li>
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<li>États-Unis</li>
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{{Explor lien
   |wiki=    Wicri/Asie
   |area=    AustralieFrV1
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     Pascal:13-0314576
   |texte=   Cardiac-Resynchronization Therapy in Heart Failure with a Narrow QRS Complex
}}

This area was generated with Dilib version V0.6.33.
Data generation: Tue Dec 5 10:43:12 2017. Site generation: Tue Mar 5 14:07:20 2024

	Serveur d'exploration sur les relations entre la France et l'Australie
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration sur les relations entre la France et l'Australie

Cardiac-Resynchronization Therapy in Heart Failure with a Narrow QRS Complex

Cardiac-Resynchronization Therapy in Heart Failure with a Narrow QRS Complex

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English descriptors

Abstract

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