Prevention of Disease Progression by Cardiac Resynchronization Therapy in Patients With Asymptomatic or Mildly Symptomatic Left Ventricular DysfunctionInsights From the European Cohort of the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) Trial
Claude Daubert, MD*,*,
Michael R. Gold, MD, PhD ,
William T. Abraham, MD, PhD ,
Stefano Ghio, MD ,
Christian Hassager, MD, PhD||,
Grahame Goode, MD¶,
Tamás Szili-Török, MD#,
Cecilia Linde, MD, PhD** on behalf of the REVERSE Study Group
* Département de Cardiologie et maladies vasculaires, CHU, Rennes, France
Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina
Division of Cardiovascular Medicine and the Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
|| Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
¶ Cardiology Research, Lancashire Cardiac Centre, Blackpool Victoria Hospital NHS Trust, Blackpool, United Kingdom
# Hungarian Institute of Cardiology, Budapest, Hungary
** Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
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Figure 2 The Primary End Point, the HF Clinical Composite Response at 6, 12, 18, and 24 Months
The p values compare percent worsened in CRT OFF versus CRT ON at each time point; n = 262 European patients at each time point. Error bars are exact 95% confidence intervals. CRT OFF = control group; CRT ON = actively treated group; HF = heart failure; NYHA = New York Heart Association.
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Figure 3 Effect of CRT on Left Ventricular Dimensions and Function: Changes in Mean
(A) Left ventricular end systolic volume index (LVESVi), (B) left ventricular end diastolic volume index (LVEDVi), and (C) left ventricular ejection fraction (LVEF) between baseline and 24 months, in each study group. Error bars indicate 95% confidence intervals. At each time point, all patients with data are included in the mean calculation. CRT OFF = control group; CRT ON = actively treated group.
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Figure 4 Effect of CRT on the HF Clinical Composite Response Among Pre-Specified Study Subgroups
Analysis of the percentage of patients worsened, according to the HF clinical composite end point, with odds ratios and 95% confidence intervals (CIs). Lower odds ratios favor CRT ON. An odds ratio of 0.5 means that the likelihood of being worsened with CRT ON is 50% of that with CRT OFF. The subgroups of age, systolic blood pressure, ejection fraction, end-systolic volume index, QRS width, interventricular mechanical delay (IVMD), and glomerular filtration rate are divided according to the median value in the entire study sample, including the U.S. patients. ICD = implantable cardioverter-defibrillator; other abbreviations as in Figure 2.
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Figure 5 Time to First HF Hospital Stay or Death, Time to First HF Hospital Stay, and Time to Death From Any Cause
Time to first hospital stay for HF or death from any cause (A), time to first hospital stay for HF (B), and time to death from any cause (C). The p values are from the log-rank test. CRT OFF = control group; CRT ON = actively treated group; HR = hazard ratio.
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