New Data on the Benefit of Cardiac Devices in Heart Failure Patients Presented At ESC Congress 2008.
Analyses Further Support Use of Cardiac Resynchronisation Therapy in Asymptomatic and Mildly Symptomatic Heart Failure Patients
MINNEAPOLIS & MUNICH, Germany -- New analyses presented today during the annual congress of the European Society of Cardiology The European Society of Cardiology (ESC) represents more than 50,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the impact of cardiovascular disease in Europe. (ESC See escape character and escape key. See also ESC/P.
ESC - escape ) on the effects of cardiac resynchronisation therapy (CRT (1) (C RunTime) See runtime library.
(2) (Cathode Ray Tube) A vacuum tube used as a display screen in a computer monitor or TV. The viewing end of the tube is coated with phosphors, which emit light when struck by electrons. ) in patients with mild heart failure from the REVERSE (Resynchronisation Reverses Remodeling remodeling /re·mod·el·ing/ (re-mod´el-ing) reorganization or renovation of an old structure.
bone remodeling in Systolic Systolic
The phase of blood circulation in which the heart's pumping chambers (ventricles) are actively pumping blood. The ventricles are squeezing (contracting) forcefully, and the pressure against the walls of the arteries is at its highest. Left Ventricular Dysfunction ventricular dysfunction,
n an abnormality in contraction and wall motion within the ventricles. ) trial show improvement in several areas, including left ventricular ejection fraction (LVEF LVEF Left ventricular ejection fraction. See Ejection fraction. ), a standard measure of the heart's pumping effectiveness and a key indicator of heart health. Patients with CRT experienced improvement in LVEF from 28 percent at baseline to 35 percent at 18 months; a healthy heart's pumping effectiveness ranges from 50 to 75 percent.
The new analyses also demonstrate the ability of CRT to prevent or slow the progression of the disease in patients with mild heart failure.
Led by Prof. Cecilia Linde, M.D., Ph.D., of Karolinska University Hospital The Karolinska University Hospital or Karolinska Universitetssjukhuset is a university hospital in Stockholm, Sweden, with two major sites in the municipalities of Huddinge and Solna. , Stockholm, Sweden, and supported by Medtronic, Inc. (NYSE NYSE
See: New York Stock Exchange : MDT MDT
Mountain Daylight Time
MDT (in the US and Canada) Mountain Daylight Time
MDT n abbr (US) (= mountain daylight time) → ), REVERSE is the first large-scale, global, randomised Adj. 1. randomised - set up or distributed in a deliberately random way
irregular - contrary to rule or accepted order or general practice; "irregular hiring practices" , double-blind trial to evaluate CRT in mildly symptomatic heart-failure patients or asymptomatic patients who previously had heart failure symptoms.
"The positive results we are seeing from CRT in patients with mild heart failure are similar to those reported in patients with more advanced disease studied in earlier trials," said Prof. Linde. "When we started the REVERSE trial, we found that although the patients had mild symptoms and were well treated with recommended drug therapies, their hearts didn't function very well in the left ventricle. These patients need treatment options beyond medication, such as CRT."
The new analyses presented at the ESC Congress included detailed data on the heart's left-ventricular function obtained via cardiac ultrasound. In addition to LVEF improvements seen at 18 months, a measure of the heart's volume and size (left ventricular end-systolic volume index, or LVESVi) improved with CRT from 95 ml/m2 at the start of the trial to 68 ml/m2 after 18 months. No similar improvements were seen in patients who did not receive CRT. These improvements are significant because cardiac structure and remodeling can correlate with improvements in patients' health in terms of delayed time to heart failure hospitalisations, which also was observed in the REVERSE study at 18 months.
Twelve-month REVERSE data has been presented at a number of scientific congresses in Europe and the United States. Despite the trial not meeting statistical significance for its primary endpoint (percent of patients worsened at 12 months using a heart failure Clinical Composite Score), the data showed that more patients in the trial improved with CRT. The findings of the 12-month data were maintained at 18 months. The European, blinded cohort in the REVERSE trial continues to be followed for a total of 24 months; additional data on the effects of CRT over that time period will be released in the future.
CRT has been established as a proven life-saving therapy for patients with advanced stages of heart failure. However, REVERSE is the first large-scale trial to show that heart failure patients with milder symptoms, or no symptoms at all, might benefit from the therapy.
Editor's Note: The latest REVERSE trial data was presented by Prof. Cecilia Linde 3 September at the ESC Congress. To arrange an interview with Prof. Linde, please contact Tracy McNulty at 612.819.2190.
Caution: The CRT devices used in the REVERSE trial are investigational for the patient population studied; their use is limited by federal (or United States) law.
Medtronic, Inc. (www.medtronic.com), headquartered in Minneapolis, is the global leader in medical technology - alleviating pain, restoring health, and extending life for millions of people around the world.
Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's Annual Report on Form 10-K for the year ended April 25, 2008. Actual results may differ materially from anticipated results.