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European Heart Journal Advance Access published online on January 27, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi734
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received July 2, 2005
Revised December 17, 2005
Accepted December 22, 2005

Review

Effects of cardiac resynchronization therapy on disease progression in chronic heart failure

Erwan Donal 1, Christophe Leclercq 1, Cecilia Linde 2, and Jean-Claude Daubert 1 *

1 Department of Cardiology, Hôpital Pontchaillou-CHU, 2, rue Henri Le Guilloux, 35033 Rennes, Cedex 09, France
2 Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden

* To whom correspondence should be addressed.
Jean-Claude Daubert, E-mail: jean-claude.daubert{at}chu-rennes.fr


  Abstract

Despite the alleviation of symptoms and longer survival conferred by pharmacological management of chronic congestive heart failure (CHF), this progressive syndrome remains associated with high morbidity and premature death. A new treatment of CHF should ideally alleviate symptoms, improve functional capacity, decrease mortality, and slow or reverse its progression without adding risks for the patient that outweighs the benefits. Growing evidence indicates that devices implanted to resynchronize ventricular contraction are a beneficial adjunct in the treatment of CHF. This review discusses the remodelling process, and its clinical and prognostic significance. We also discuss the impact of CRT, on remodelling and disease progression with a particular focus on patients with asymptomatic or mild heart failure (NYHA Class I-II).

Keywords: Cardiac resynchronization therapy; Heart failure; Disease progression; Ventricular remodelling.
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