Trajectory of left ventricular ejection fraction among individuals eligible for implantable cardioverter-defibrillator

Selma Carlson; Amy Gravely; Selçuk Adabag

doi:10.1111/pace.14168

Trajectory of left ventricular ejection fraction among individuals eligible for implantable cardioverter-defibrillator

Selma Carlson, Amy Gravely, Selçuk Adabag

Medicine - Veteran's Administration Medical Center

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

3 Scopus citations

Abstract

OBJECTIVE: Examine the trajectory of left ventricular ejection fraction (EF) among patients eligible for implantable cardioverter-defibrillator (ICD) therapy.

BACKGROUND: EF is the cornerstone criterion for ICD therapy, but the risk of sudden cardiac death remains after an improvement in EF.

METHODS: We examined the trajectory of EF among 1178 participants of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) who had three or more assessments of EF, at least 90 days apart. A follow-up EF > 35% or >10% absolute increase in EF from baseline were examined as the criteria for EF improvement.

RESULTS: At first follow-up, 381 (32%) patients had an improvement of EF to >35%. However, EF had returned back to ≤35% in 109 (27%) of these patients at second follow-up. Similarly, 446 (38%) patients experienced a >10% improvement in EF at first follow-up, but 109 (24%) of these had a subsequent >10% decrease in EF at the second follow-up. Of the 32 patients with normalized EF (≥55%) at first follow-up, 18 (56%) had a subsequent >10% decrease in EF. The fluctuation in EF was present in both ischemic and nonischemic cardiomyopathy but a higher proportion of patients with nonischemic cardiomyopathy had an improvement in EF to >35% at first follow-up compared to those with ischemic cardiomyopathy (38% vs. 27%, p = < .0001).

CONCLUSION: There is substantial fluctuation of EF among patients who are eligible for ICD therapy.

Original language	English (US)
Pages (from-to)	800-806
Number of pages	7
Journal	PACE - Pacing and Clinical Electrophysiology
Volume	44
Issue number	5
DOIs	https://doi.org/10.1111/pace.14168
State	Published - May 2021

Bibliographical note

Funding Information:
We are grateful to the SCD-HeFT trial investigators and to NHLBI BioLINCC for the opportunity to access these data. This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the United States Department of Veterans Affairs or the US government.

Funding Information:
Dr. Selçuk Adabag has received research grants from Medtronic.

Publisher Copyright:
© 2021 Wiley Periodicals LLC

Keywords

EF
ICD
LVEF
cardiomyopathy
ejection fraction
heart failure
implantable cardioverter-defibrillator
trajectory

PubMed: MeSH publication types

Journal Article
Randomized Controlled Trial

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/pace.14168

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title = "Trajectory of left ventricular ejection fraction among individuals eligible for implantable cardioverter-defibrillator",

abstract = "OBJECTIVE: Examine the trajectory of left ventricular ejection fraction (EF) among patients eligible for implantable cardioverter-defibrillator (ICD) therapy.BACKGROUND: EF is the cornerstone criterion for ICD therapy, but the risk of sudden cardiac death remains after an improvement in EF.METHODS: We examined the trajectory of EF among 1178 participants of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) who had three or more assessments of EF, at least 90 days apart. A follow-up EF > 35% or >10% absolute increase in EF from baseline were examined as the criteria for EF improvement.RESULTS: At first follow-up, 381 (32%) patients had an improvement of EF to >35%. However, EF had returned back to ≤35% in 109 (27%) of these patients at second follow-up. Similarly, 446 (38%) patients experienced a >10% improvement in EF at first follow-up, but 109 (24%) of these had a subsequent >10% decrease in EF at the second follow-up. Of the 32 patients with normalized EF (≥55%) at first follow-up, 18 (56%) had a subsequent >10% decrease in EF. The fluctuation in EF was present in both ischemic and nonischemic cardiomyopathy but a higher proportion of patients with nonischemic cardiomyopathy had an improvement in EF to >35% at first follow-up compared to those with ischemic cardiomyopathy (38% vs. 27%, p = < .0001).CONCLUSION: There is substantial fluctuation of EF among patients who are eligible for ICD therapy.",

keywords = "EF, ICD, LVEF, cardiomyopathy, ejection fraction, heart failure, implantable cardioverter-defibrillator, trajectory",

author = "Selma Carlson and Amy Gravely and Sel{\c c}uk Adabag",

note = "Funding Information: We are grateful to the SCD-HeFT trial investigators and to NHLBI BioLINCC for the opportunity to access these data. This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the United States Department of Veterans Affairs or the US government. Funding Information: Dr. Sel{\c c}uk Adabag has received research grants from Medtronic. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",

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T1 - Trajectory of left ventricular ejection fraction among individuals eligible for implantable cardioverter-defibrillator

AU - Carlson, Selma

AU - Gravely, Amy

AU - Adabag, Selçuk

N1 - Funding Information: We are grateful to the SCD-HeFT trial investigators and to NHLBI BioLINCC for the opportunity to access these data. This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the United States Department of Veterans Affairs or the US government. Funding Information: Dr. Selçuk Adabag has received research grants from Medtronic. Publisher Copyright: © 2021 Wiley Periodicals LLC

PY - 2021/5

Y1 - 2021/5

N2 - OBJECTIVE: Examine the trajectory of left ventricular ejection fraction (EF) among patients eligible for implantable cardioverter-defibrillator (ICD) therapy.BACKGROUND: EF is the cornerstone criterion for ICD therapy, but the risk of sudden cardiac death remains after an improvement in EF.METHODS: We examined the trajectory of EF among 1178 participants of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) who had three or more assessments of EF, at least 90 days apart. A follow-up EF > 35% or >10% absolute increase in EF from baseline were examined as the criteria for EF improvement.RESULTS: At first follow-up, 381 (32%) patients had an improvement of EF to >35%. However, EF had returned back to ≤35% in 109 (27%) of these patients at second follow-up. Similarly, 446 (38%) patients experienced a >10% improvement in EF at first follow-up, but 109 (24%) of these had a subsequent >10% decrease in EF at the second follow-up. Of the 32 patients with normalized EF (≥55%) at first follow-up, 18 (56%) had a subsequent >10% decrease in EF. The fluctuation in EF was present in both ischemic and nonischemic cardiomyopathy but a higher proportion of patients with nonischemic cardiomyopathy had an improvement in EF to >35% at first follow-up compared to those with ischemic cardiomyopathy (38% vs. 27%, p = < .0001).CONCLUSION: There is substantial fluctuation of EF among patients who are eligible for ICD therapy.

AB - OBJECTIVE: Examine the trajectory of left ventricular ejection fraction (EF) among patients eligible for implantable cardioverter-defibrillator (ICD) therapy.BACKGROUND: EF is the cornerstone criterion for ICD therapy, but the risk of sudden cardiac death remains after an improvement in EF.METHODS: We examined the trajectory of EF among 1178 participants of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) who had three or more assessments of EF, at least 90 days apart. A follow-up EF > 35% or >10% absolute increase in EF from baseline were examined as the criteria for EF improvement.RESULTS: At first follow-up, 381 (32%) patients had an improvement of EF to >35%. However, EF had returned back to ≤35% in 109 (27%) of these patients at second follow-up. Similarly, 446 (38%) patients experienced a >10% improvement in EF at first follow-up, but 109 (24%) of these had a subsequent >10% decrease in EF at the second follow-up. Of the 32 patients with normalized EF (≥55%) at first follow-up, 18 (56%) had a subsequent >10% decrease in EF. The fluctuation in EF was present in both ischemic and nonischemic cardiomyopathy but a higher proportion of patients with nonischemic cardiomyopathy had an improvement in EF to >35% at first follow-up compared to those with ischemic cardiomyopathy (38% vs. 27%, p = < .0001).CONCLUSION: There is substantial fluctuation of EF among patients who are eligible for ICD therapy.

KW - EF

KW - ICD

KW - LVEF

KW - cardiomyopathy

KW - ejection fraction

KW - heart failure

KW - implantable cardioverter-defibrillator

KW - trajectory

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JO - PACE - Pacing and Clinical Electrophysiology

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ER -

Trajectory of left ventricular ejection fraction among individuals eligible for implantable cardioverter-defibrillator

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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