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Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy

In patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), three months of optimal therapy are recommended before considering a primary preventive implantable cardioverter-defibrillator (ICD). It is unclear which patients benefit from a prolonged waiting period under prot...

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Autores principales: Mueller-Leisse, Johanna, Brunn, Johanna, Zormpas, Christos, Hohmann, Stephan, Hillmann, Henrike Aenne Katrin, Eiringhaus, Jörg, Bauersachs, Johann, Veltmann, Christian, Duncker, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914738/
https://www.ncbi.nlm.nih.gov/pubmed/35271182
http://dx.doi.org/10.3390/s22052037
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author Mueller-Leisse, Johanna
Brunn, Johanna
Zormpas, Christos
Hohmann, Stephan
Hillmann, Henrike Aenne Katrin
Eiringhaus, Jörg
Bauersachs, Johann
Veltmann, Christian
Duncker, David
author_facet Mueller-Leisse, Johanna
Brunn, Johanna
Zormpas, Christos
Hohmann, Stephan
Hillmann, Henrike Aenne Katrin
Eiringhaus, Jörg
Bauersachs, Johann
Veltmann, Christian
Duncker, David
author_sort Mueller-Leisse, Johanna
collection PubMed
description In patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), three months of optimal therapy are recommended before considering a primary preventive implantable cardioverter-defibrillator (ICD). It is unclear which patients benefit from a prolonged waiting period under protection of the wearable cardioverter-defibrillator (WCD) to avoid unnecessary ICD implantations. This study included all patients receiving a WCD for newly diagnosed HFrEF (n = 353) at our center between 2012 and 2017. Median follow-up was 2.7 years. From baseline until three months, LVEF improved in patients with all peripartum cardiomyopathy (PPCM), myocarditis, dilated cardiomyopathy (DCM), or ischemic cardiomyopathy (ICM). Beyond this time, LVEF improved in PPCM and DCM only (10 ± 8% and 10 ± 12%, respectively), whereas patients with ICM showed no further improvement. The patients with newly diagnosed HFrEF were compared to 29 patients with a distinct WCD indication, which is an explantation of an infected ICD. This latter group had a higher incidence of WCD shocks and poorer overall survival. All-cause mortality should be considered when deciding on WCD prescription. In patients with newly diagnosed HFrEF, the potential for delayed LVEF recovery should be considered when timing ICD implantation, especially in patients with PPCM and DCM.
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spelling pubmed-89147382022-03-12 Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy Mueller-Leisse, Johanna Brunn, Johanna Zormpas, Christos Hohmann, Stephan Hillmann, Henrike Aenne Katrin Eiringhaus, Jörg Bauersachs, Johann Veltmann, Christian Duncker, David Sensors (Basel) Article In patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), three months of optimal therapy are recommended before considering a primary preventive implantable cardioverter-defibrillator (ICD). It is unclear which patients benefit from a prolonged waiting period under protection of the wearable cardioverter-defibrillator (WCD) to avoid unnecessary ICD implantations. This study included all patients receiving a WCD for newly diagnosed HFrEF (n = 353) at our center between 2012 and 2017. Median follow-up was 2.7 years. From baseline until three months, LVEF improved in patients with all peripartum cardiomyopathy (PPCM), myocarditis, dilated cardiomyopathy (DCM), or ischemic cardiomyopathy (ICM). Beyond this time, LVEF improved in PPCM and DCM only (10 ± 8% and 10 ± 12%, respectively), whereas patients with ICM showed no further improvement. The patients with newly diagnosed HFrEF were compared to 29 patients with a distinct WCD indication, which is an explantation of an infected ICD. This latter group had a higher incidence of WCD shocks and poorer overall survival. All-cause mortality should be considered when deciding on WCD prescription. In patients with newly diagnosed HFrEF, the potential for delayed LVEF recovery should be considered when timing ICD implantation, especially in patients with PPCM and DCM. MDPI 2022-03-05 /pmc/articles/PMC8914738/ /pubmed/35271182 http://dx.doi.org/10.3390/s22052037 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mueller-Leisse, Johanna
Brunn, Johanna
Zormpas, Christos
Hohmann, Stephan
Hillmann, Henrike Aenne Katrin
Eiringhaus, Jörg
Bauersachs, Johann
Veltmann, Christian
Duncker, David
Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
title Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
title_full Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
title_fullStr Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
title_full_unstemmed Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
title_short Delayed Improvement of Left Ventricular Function in Newly Diagnosed Heart Failure Depends on Etiology—A PROLONG-II Substudy
title_sort delayed improvement of left ventricular function in newly diagnosed heart failure depends on etiology—a prolong-ii substudy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914738/
https://www.ncbi.nlm.nih.gov/pubmed/35271182
http://dx.doi.org/10.3390/s22052037
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