Clinical Effects of Cardiac Contractility Modulation in Heart Failure with Mildly Reduced Systolic Function

作者：Carsten Tschöpe, Javed Butler, Dimitrios Farmakis, Deborah Morley, Ishu Rao, Gerasimos Filippatos · 发表于：ESC Heart Failure · 年份：2020 · DOI：10.1002/ehf2.13126 · 被引用次数：15 · 研究领域：Heart Failure Treatment and Management、Cardiovascular Function and Risk Factors、Cardiac pacing and defibrillation studies

Abstract Aims Increasing attention is being given to patients with heart failure and ‘mid-range’ left ventricular ejection fraction (LVEF, ≥40% and <50%) for whom there are no approved therapies that improve prognosis. We aim to assess for the first time the effects of cardiac contractility modulation (CCM) therapy in this patient population. Methods and results We assessed the effects of 6- month CCM therapy on functional status, exercise tolerance and quality of life in a subgroup of 53 patients with a LVEF of 40–45% recruited in previous CCM studies, including 37 patients in the CCM group and 16 in the control group. New York Heart Association classification improved by ≥1 class from baseline to 24 weeks in 80.6% (95% confidence interval [62.5%, 92.5%]) of patients in the CCM group compared with 57.1% in the control group (95% confidence interval [28.9%, 82.3%], P = 0.15). Six-minute walk distance increased significantly in the CCM group with a net between-group treatment effect of 53.9 ± 74.2 m (P = 0.05). Peak VO2 improved in the CCM group with a net between-group treatment effect of 2.0 ± 2.8 mL/kg/min (P = 0.02). Minnesota Living with Heart Failure Questionnaire score decreased from baseline to 24 weeks with a net between-group treatment effect of −13.1 ± 21.0 (P = 0.10). There were no significant differences in the adverse event rate between the CCM and control groups. Conclusions These preliminary results suggest that CCM exerts favourable effects on exercise toleran...