Duration of reverse remodeling response to cardiac resynchronization therapy: Rates, predictors, and clinical outcomes

Takafumi Oka, Koichi Inoue, Koji Tanaka, Yuko Toyoshima, Takaaki Isshiki, Takeshi Kimura, Masakiyo Nobuyoshi, Satoshi Shizuta, Takeshi Arita, Satoki Fujii, Katsuomi Iwakura, Kenshi Fujii, Kenji Ando

Research output: Contribution to journalArticle

5 Citations (Scopus)


Background A subset of patients undergoing cardiac resynchronization therapy (CRT) for heart failure (HF) with severe left ventricular (LV) dysfunction experience only short-lived LV reverse remodeling. Little is known about the incidence and prognosis of this finding. We sought to identify predictors of a brief response and investigated the prognosis in a retrospective study. Methods A total of 528 patients from a Japanese multicenter database with full echocardiography datasets were enrolled. Follow-up was 3.4 ± 1.3 years. Based on relative reduction in LV end-systolic volume (LVESV) at 6 months, we categorized patients as responders (reduction in LVESV ≥ 15%) and non-responders (NRs; reduction in LVESV < 15%). Based on reduction in LVESV at 1–2 years, responders were subdivided into long-lasting responders (reduction in LVESV ≥ 15%) and brief responders (reduction in LVESV < 15%). Results Of 328 responders, 50 (15%) were brief responders. Predictors of brief response were prior ventricular tachyarrhythmia, a non-left bundle-branch block (LBBB) intrinsic QRS pattern, and prior hospitalization for HF. The risk of all-cause death in brief responders was significantly lower than that in NRs (P = 0.034) and tended to be higher than that in long-lasting responders (P = 0.080). Conclusions Approximately 15% of responders were brief responders. Prior ventricular tachyarrhythmia, a non-LBBB pattern, and HF hospitalization were independent predictors of a brief response. Brief response was significantly associated with decreased risk of all-cause death compared with NRs and had a tendency toward increased risk of all-cause death compared with long-lasting responders.

Original languageEnglish
Pages (from-to)340-346
Number of pages7
JournalInternational Journal of Cardiology
Publication statusPublished - Sep 15 2017


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this