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European Journal of Heart Failure
Article . 2022 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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The response to cardiac resynchronization therapy in LMNA cardiomyopathy

Authors: Sidhu K.; Castrini A. I.; Parikh V.; Reza N.; Owens A.; Tremblay-Gravel M.; Wheeler M. T.; +18 Authors

The response to cardiac resynchronization therapy in LMNA cardiomyopathy

Abstract

Aims Cardiac implantable electronic device (CIED) therapy is fundamental to the management of LMNA cardiomyopathy due to the high frequency of atrioventricular block and ventricular tachyarrhythmias. We aimed to define the role of cardiac resynchronization therapy (CRT) in impacting heart failure in LMNA cardiomyopathy. Methods and results From nine referral centres, LMNA cardiomyopathy patients who underwent CRT with available pre‐ and post‐echocardiograms were identified retrospectively. Factors associated with CRT response were identified (defined as improvement in left ventricular ejection fraction [LVEF] ≥5% 6 months post‐implant) and the associated impact on the primary outcome of death, implantation of a left ventricular assist device or cardiac transplantation was assessed. We identified 105 patients (mean age 51 ± 10 years) undergoing CRT, including 70 (67%) who underwent CRT as a CIED upgrade. The mean change in LVEF ∼6 months post‐CRT was +4 ± 9%. A CRT response occurred in 40 (38%) patients and was associated with lower baseline LVEF or a high percentage of right ventricular pacing prior to CRT in patients with pre‐existing CIED. In patients with a European Society of Cardiology class I guideline indication for CRT, response rates were 61%. A CRT response was evident at thresholds of LVEF ≤45% or percent pacing ≥50%. There was a 1.3 year estimated median difference in event‐free survival in those who responded to CRT ( p = 0.04). Conclusion Systolic function improves in patients with LMNA cardiomyopathy who undergo CRT, especially with strong guideline indications for implantation. Post‐CRT improvements in LVEF are associated with survival benefits in this population with otherwise limited options.

Country
Italy
Keywords

Adult, Heart Failure, Cardiac resynchronization therapy, Lamin A/C, Dilated cardiomyopathy, Heart failure, Stroke Volume, Middle Aged, Lamin Type A, Ventricular Function, Left, Cardiac Resynchronization Therapy, Treatment Outcome, Humans, Cardiac resynchronization therapy; Dilated cardiomyopathy; Heart failure; Lamin A/C, Cardiomyopathies, Retrospective Studies

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
21
Top 10%
Top 10%
Top 10%
Green