Transcatheter Left Ventricular Restoration in Patients With Heart Failure

NADIRA Hamid; ULRICH P. JORDE; M. A.R.K. REISMAN; AZEEM LATIB; D. SCOTT LIM; SUSAN M. JOSEPH; ALENA KURLIANSKAYA; O. L.E.G. POLONETSKY; P. E.T.R. NEUZIL; VIVEK REDDY; JASON FOERST; HEMAL GADA; KENDRA J. GRUBB; GUILHERME SILVA; D. E.A.N. KEREIAKES; SATYA SHREENIVAS; S. E.A.N. PINNEY; GIEDRIUS DAVIDAVICIUS; P. A.U.L. SORAJJA; JOHN P. BOEHMER; FRANZ X. KLEBER; PATRICK PERIER; NICOLAS M. VAN MIEGHEM; NICOLAS DUMONTEIL; MARTIN B. LEON; DANIEL BURKHOFF

doi:10.1016/j.cardfail.2023.03.003

Transcatheter Left Ventricular Restoration in Patients With Heart Failure

NADIRA Hamid, ULRICH P. JORDE, M. A.R.K. REISMAN, AZEEM LATIB, D. SCOTT LIM, SUSAN M. JOSEPH, ALENA KURLIANSKAYA, O. L.E.G. POLONETSKY, P. E.T.R. NEUZIL, VIVEK REDDY, JASON FOERST, HEMAL GADA, KENDRA J. GRUBB, GUILHERME SILVA, D. E.A.N. KEREIAKES, SATYA SHREENIVAS, S. E.A.N. PINNEY, GIEDRIUS DAVIDAVICIUS, P. A.U.L. SORAJJA, JOHN P. BOEHMERFRANZ X. KLEBER, PATRICK PERIER, NICOLAS M. VAN MIEGHEM, NICOLAS DUMONTEIL, MARTIN B. LEON, DANIEL BURKHOFF

Medicine

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background: Left ventricular (LV) volume reshaping reduces myocardial wall stress and may induce reverse remodeling in patients with heart failure with reduced ejection fraction. The AccuCinch Transcatheter Left Ventricular Restoration system consists of a series of anchors connected by a cable implanted along the LV base that is cinched to the basal free wall radius. We evaluated the echocardiographic and clinical outcomes following transcatheter left ventricular restoration. Methods and Results: We analyzed 51 heart failure patients with a left ventricular ejection fraction between 20% and 40%, with no more than 2+ mitral regurgitation treated with optimal medical therapy, who subsequently underwent transcatheter left ventricular restoration. Serial echocardiograms, Kansas City Cardiomyopathy Questionnaire scores, and 6-minute walk test distances were measured at baseline through 12 months. Primary analysis end point was change in end-diastolic volume at 12 months compared with baseline. Patients (n = 51) were predominantly male (86%) with a mean age of 56.3 ± 13.1 years. Fluoroscopy showed LV free wall radius decreased by a median of 9.2 mm amounting to a 29.6% decrease in the free wall arc length. At 12 months, the LV end-diastolic volume decreased by 33.6 ± 34.8 mL (P < .01), with comparable decreases in the LV end-systolic volume. These decreases were associated with significant improvements in the overall Kansas City Cardiomyopathy Questionnaire score (16.4 ± 18.7 points; P < .01) and 6-minute hall walk test distance (45.9 ± 83.9 m; P < .01). There were no periprocedural deaths; through the 1-year follow-up, 1 patient died (day 280) and 1 patient received a left ventricular assist device (day 13). Conclusions: In patients with heart failure with reduced ejection fraction without significant mitral regurgitation receiving optimal medical therapy, the AccuCinch System resulted in decreases of LV volume, as well as improved quality of life and exercise endurance. A randomized trial is ongoing (NCT04331769).

Original language	English (US)
Pages (from-to)	1046-1055
Number of pages	10
Journal	Journal of Cardiac Failure
Volume	29
Issue number	7
DOIs	https://doi.org/10.1016/j.cardfail.2023.03.003
State	Published - Jul 2023

Keywords

Transcatheter
heart failure
left ventricle

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.cardfail.2023.03.003

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Hamid, NADIRA., JORDE, ULRICH. P., REISMAN, M. A. R. K., LATIB, AZEEM., LIM, D. SCOTT., JOSEPH, SUSAN. M., KURLIANSKAYA, ALENA., POLONETSKY, O. L. E. G., NEUZIL, P. E. T. R., REDDY, VIVEK., FOERST, JASON., GADA, HEMAL., GRUBB, KENDRA. J., SILVA, GUILHERME., KEREIAKES, D. E. A. N., SHREENIVAS, SATYA., PINNEY, S. E. A. N., DAVIDAVICIUS, GIEDRIUS., SORAJJA, P. A. U. L., ... BURKHOFF, DANIEL. (2023). Transcatheter Left Ventricular Restoration in Patients With Heart Failure. Journal of Cardiac Failure, 29(7), 1046-1055. https://doi.org/10.1016/j.cardfail.2023.03.003

Hamid, NADIRA, JORDE, ULRICHP, REISMAN, MARK, LATIB, AZEEM, LIM, DSCOTT, JOSEPH, SUSANM, KURLIANSKAYA, ALENA, POLONETSKY, OLEG, NEUZIL, PETR, REDDY, VIVEK, FOERST, JASON, GADA, HEMAL, GRUBB, KENDRAJ, SILVA, GUILHERME, KEREIAKES, DEAN, SHREENIVAS, SATYA, PINNEY, SEAN, DAVIDAVICIUS, GIEDRIUS, SORAJJA, PAUL, BOEHMER, JOHNP, KLEBER, FRANZX, PERIER, PATRICK, VAN MIEGHEM, NICOLASM, DUMONTEIL, NICOLAS, LEON, MARTINB & BURKHOFF, DANIEL 2023, 'Transcatheter Left Ventricular Restoration in Patients With Heart Failure', Journal of Cardiac Failure, vol. 29, no. 7, pp. 1046-1055. https://doi.org/10.1016/j.cardfail.2023.03.003

@article{1f62e46a03a24f40a71b310635250563,

title = "Transcatheter Left Ventricular Restoration in Patients With Heart Failure",

abstract = "Background: Left ventricular (LV) volume reshaping reduces myocardial wall stress and may induce reverse remodeling in patients with heart failure with reduced ejection fraction. The AccuCinch Transcatheter Left Ventricular Restoration system consists of a series of anchors connected by a cable implanted along the LV base that is cinched to the basal free wall radius. We evaluated the echocardiographic and clinical outcomes following transcatheter left ventricular restoration. Methods and Results: We analyzed 51 heart failure patients with a left ventricular ejection fraction between 20% and 40%, with no more than 2+ mitral regurgitation treated with optimal medical therapy, who subsequently underwent transcatheter left ventricular restoration. Serial echocardiograms, Kansas City Cardiomyopathy Questionnaire scores, and 6-minute walk test distances were measured at baseline through 12 months. Primary analysis end point was change in end-diastolic volume at 12 months compared with baseline. Patients (n = 51) were predominantly male (86%) with a mean age of 56.3 ± 13.1 years. Fluoroscopy showed LV free wall radius decreased by a median of 9.2 mm amounting to a 29.6% decrease in the free wall arc length. At 12 months, the LV end-diastolic volume decreased by 33.6 ± 34.8 mL (P < .01), with comparable decreases in the LV end-systolic volume. These decreases were associated with significant improvements in the overall Kansas City Cardiomyopathy Questionnaire score (16.4 ± 18.7 points; P < .01) and 6-minute hall walk test distance (45.9 ± 83.9 m; P < .01). There were no periprocedural deaths; through the 1-year follow-up, 1 patient died (day 280) and 1 patient received a left ventricular assist device (day 13). Conclusions: In patients with heart failure with reduced ejection fraction without significant mitral regurgitation receiving optimal medical therapy, the AccuCinch System resulted in decreases of LV volume, as well as improved quality of life and exercise endurance. A randomized trial is ongoing (NCT04331769).",

keywords = "Transcatheter, heart failure, left ventricle",

author = "NADIRA Hamid and JORDE, {ULRICH P.} and REISMAN, {M. A.R.K.} and AZEEM LATIB and LIM, {D. SCOTT} and JOSEPH, {SUSAN M.} and ALENA KURLIANSKAYA and POLONETSKY, {O. L.E.G.} and NEUZIL, {P. E.T.R.} and VIVEK REDDY and JASON FOERST and HEMAL GADA and GRUBB, {KENDRA J.} and GUILHERME SILVA and KEREIAKES, {D. E.A.N.} and SATYA SHREENIVAS and PINNEY, {S. E.A.N.} and GIEDRIUS DAVIDAVICIUS and SORAJJA, {P. A.U.L.} and BOEHMER, {JOHN P.} and KLEBER, {FRANZ X.} and PATRICK PERIER and {VAN MIEGHEM}, {NICOLAS M.} and NICOLAS DUMONTEIL and LEON, {MARTIN B.} and DANIEL BURKHOFF",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = jul,

doi = "10.1016/j.cardfail.2023.03.003",

language = "English (US)",

volume = "29",

pages = "1046--1055",

journal = "Journal of Cardiac Failure",

issn = "1071-9164",

publisher = "Churchill Livingstone",

number = "7",

}

TY - JOUR

T1 - Transcatheter Left Ventricular Restoration in Patients With Heart Failure

AU - Hamid, NADIRA

AU - JORDE, ULRICH P.

AU - REISMAN, M. A.R.K.

AU - LATIB, AZEEM

AU - LIM, D. SCOTT

AU - JOSEPH, SUSAN M.

AU - KURLIANSKAYA, ALENA

AU - POLONETSKY, O. L.E.G.

AU - NEUZIL, P. E.T.R.

AU - REDDY, VIVEK

AU - FOERST, JASON

AU - GADA, HEMAL

AU - GRUBB, KENDRA J.

AU - SILVA, GUILHERME

AU - KEREIAKES, D. E.A.N.

AU - SHREENIVAS, SATYA

AU - PINNEY, S. E.A.N.

AU - DAVIDAVICIUS, GIEDRIUS

AU - SORAJJA, P. A.U.L.

AU - BOEHMER, JOHN P.

AU - KLEBER, FRANZ X.

AU - PERIER, PATRICK

AU - VAN MIEGHEM, NICOLAS M.

AU - DUMONTEIL, NICOLAS

AU - LEON, MARTIN B.

AU - BURKHOFF, DANIEL

PY - 2023/7

Y1 - 2023/7

N2 - Background: Left ventricular (LV) volume reshaping reduces myocardial wall stress and may induce reverse remodeling in patients with heart failure with reduced ejection fraction. The AccuCinch Transcatheter Left Ventricular Restoration system consists of a series of anchors connected by a cable implanted along the LV base that is cinched to the basal free wall radius. We evaluated the echocardiographic and clinical outcomes following transcatheter left ventricular restoration. Methods and Results: We analyzed 51 heart failure patients with a left ventricular ejection fraction between 20% and 40%, with no more than 2+ mitral regurgitation treated with optimal medical therapy, who subsequently underwent transcatheter left ventricular restoration. Serial echocardiograms, Kansas City Cardiomyopathy Questionnaire scores, and 6-minute walk test distances were measured at baseline through 12 months. Primary analysis end point was change in end-diastolic volume at 12 months compared with baseline. Patients (n = 51) were predominantly male (86%) with a mean age of 56.3 ± 13.1 years. Fluoroscopy showed LV free wall radius decreased by a median of 9.2 mm amounting to a 29.6% decrease in the free wall arc length. At 12 months, the LV end-diastolic volume decreased by 33.6 ± 34.8 mL (P < .01), with comparable decreases in the LV end-systolic volume. These decreases were associated with significant improvements in the overall Kansas City Cardiomyopathy Questionnaire score (16.4 ± 18.7 points; P < .01) and 6-minute hall walk test distance (45.9 ± 83.9 m; P < .01). There were no periprocedural deaths; through the 1-year follow-up, 1 patient died (day 280) and 1 patient received a left ventricular assist device (day 13). Conclusions: In patients with heart failure with reduced ejection fraction without significant mitral regurgitation receiving optimal medical therapy, the AccuCinch System resulted in decreases of LV volume, as well as improved quality of life and exercise endurance. A randomized trial is ongoing (NCT04331769).

AB - Background: Left ventricular (LV) volume reshaping reduces myocardial wall stress and may induce reverse remodeling in patients with heart failure with reduced ejection fraction. The AccuCinch Transcatheter Left Ventricular Restoration system consists of a series of anchors connected by a cable implanted along the LV base that is cinched to the basal free wall radius. We evaluated the echocardiographic and clinical outcomes following transcatheter left ventricular restoration. Methods and Results: We analyzed 51 heart failure patients with a left ventricular ejection fraction between 20% and 40%, with no more than 2+ mitral regurgitation treated with optimal medical therapy, who subsequently underwent transcatheter left ventricular restoration. Serial echocardiograms, Kansas City Cardiomyopathy Questionnaire scores, and 6-minute walk test distances were measured at baseline through 12 months. Primary analysis end point was change in end-diastolic volume at 12 months compared with baseline. Patients (n = 51) were predominantly male (86%) with a mean age of 56.3 ± 13.1 years. Fluoroscopy showed LV free wall radius decreased by a median of 9.2 mm amounting to a 29.6% decrease in the free wall arc length. At 12 months, the LV end-diastolic volume decreased by 33.6 ± 34.8 mL (P < .01), with comparable decreases in the LV end-systolic volume. These decreases were associated with significant improvements in the overall Kansas City Cardiomyopathy Questionnaire score (16.4 ± 18.7 points; P < .01) and 6-minute hall walk test distance (45.9 ± 83.9 m; P < .01). There were no periprocedural deaths; through the 1-year follow-up, 1 patient died (day 280) and 1 patient received a left ventricular assist device (day 13). Conclusions: In patients with heart failure with reduced ejection fraction without significant mitral regurgitation receiving optimal medical therapy, the AccuCinch System resulted in decreases of LV volume, as well as improved quality of life and exercise endurance. A randomized trial is ongoing (NCT04331769).

KW - Transcatheter

KW - heart failure

KW - left ventricle

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U2 - 10.1016/j.cardfail.2023.03.003

DO - 10.1016/j.cardfail.2023.03.003

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SN - 1071-9164

VL - 29

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JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

IS - 7

ER -

Transcatheter Left Ventricular Restoration in Patients With Heart Failure

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