caa a22 4500 605479070 CHVBK 20210128100408.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s10741-015-9499-2 doi (NATIONALLICENCE)springer-10.1007/s10741-015-9499-2 Long-term outcome with cardiac resynchronization therapy in mild heart failure patients with left bundle branch block from US and Europe MADIT-CRT [Elektronische Daten] [Yitschak Biton, Valentina Kutyifa, Wojciech Zareba, Helmut Klein, Scott Solomon, Scott McNitt, Bronislava Polonsky, Arthur Moss, Ilan Goldenberg] Early intervention with cardiac resynchronization therapy with defibrillator (CRT-D) in mild heart failure (HF) patients with a left bundle branch block (LBBB) ECG pattern was associated with a significant reduction in mortality in the long-term MADIT-CRT trial. Whether patients in MADIT-CRT enrolled from centers in the USA and in Europe have different long-term clinical response to CRT-D remains unknown. We compared the baseline clinical characteristics and clinical and echocardiographic long-term clinical response to CRT-D between MADIT-CRT patients with LBBB who were enrolled in USA (n=871) and European centers (n=392). Although European patients had more advanced heart disease than US patients, CRT-D was associated with similar 60% (p<0.001) reductions in the risk of HF in US and European patients when compared to ICD-only therapy after adjustment for relevant baseline clinical covariates. US patients had significant long-term mortality reduction (38%, p=0.02) while among European patients the survival benefit associated with CRT-D was not statistically significant (HR 0.73, p=0.18); subgroup analyses revealed a significantly greater CRT-D benefit among women who were enrolled in the USA, whereas no significant gender difference in the clinical benefit of CRT-D was observed in the European cohort. Reverse remodeling at 1year was associated with significantly better clinical outcomes in both groups. Despite differences in baseline disease severity, European and US patients with LBBB experienced a similar clinical and echocardiographic response to cardiac resynchronization therapy during long-term follow-up. Clinical trial registration: http://clinicaltrials.gov/ct2/show/NCT00180271 . Springer Science+Business Media New York, 2015 Cardiac resynchronization therapy nationallicence Implantable cardioverter defibrillator nationallicence Mild heart failure nationallicence Mortality nationallicence Long-term survival nationallicence CRT : Cardiac resynchronization therapy nationallicence CRT-D : Cardiac resynchronization therapy with an implantable cardioverter defibrillator nationallicence HF : Heart failure nationallicence ICD : Implantable cardioverter defibrillator nationallicence LBBB : Left bundle branch block nationallicence LV : Left ventricular nationallicence LVEF : Left ventricular ejection fraction nationallicence LVESV : Left ventricular end-systolic volume nationallicence LVEDV : Left ventricular end-diastolic volume nationallicence LAV : Left atrial volume nationallicence NYHA : New York Heart Association nationallicence US : United States nationallicence BUN : Blood urea nitrogen nationallicence Biton Yitschak Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Kutyifa Valentina Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Zareba Wojciech Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Klein Helmut Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Solomon Scott Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut McNitt Scott Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Polonsky Bronislava Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Moss Arthur Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Goldenberg Ilan Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut Heart Failure Reviews Springer US; http://www.springer-ny.com 20/5(2015-09-01), 535-543 1382-4147 20:5<535 2015 20 10741 https://doi.org/10.1007/s10741-015-9499-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10741-015-9499-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Biton Yitschak Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Kutyifa Valentina Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Zareba Wojciech Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Klein Helmut Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Solomon Scott Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- McNitt Scott Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Polonsky Bronislava Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Moss Arthur Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 700 1- Goldenberg Ilan Heart Research Follow-Up Program, Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd., PO Box 653, 14642, Rochester, NY, USA aut NATIONALLICENCE 773 0- Heart Failure Reviews Springer US; http://www.springer-ny.com 20/5(2015-09-01), 535-543 1382-4147 20:5<535 2015 20 10741