ReverseRemodelingandtheRiskofVentricularTachyarr.pptVIP

Consistently, Multivariate analysis showed a significant differential effect of ?-blocker therapy on the outcome of patients) . ?-blocker therapy was associated with a significant 88% reduction in the risk of life threatening events among patients with C-loop-missense mutations, whereas the benefit of ?-blocker therapy was attenuated among patients with other mutations. In order to understand the mechanism underlying the increase in risk associated with C-loop mutations we measured channel basal function and regulation in four mutant channels associated with LQT1, two in the membrane spanning domains and two located in C-loops. Channel current decreased significantly for all four mutations studied when compared to wild type subunits * Reverse Remodeling and the Risk of Ventricular Tachyarrhythmias in MADIT-CRT Alon Barsheshet, MD1, Paul J. Wang, MD2, Arthur J. Moss, MD1, Scott D. Solomon, MD3, Amin Al-Ahmad, MD2, Scott McNitt, MS1, Elyse Foster, MD4, David T. Huang, MD1, Helmut U. Klein, MD1, Wojciech Zareba, MD, PhD1, Michael Eldar, MD5, Ilan Goldenberg, MD1 1Cardiology Division, University of Rochester Medical Center, Rochester, NY; 2Cardiology Division, Stanford University, Stanford, CA; 3Cardiovascular Division, Brigham and Womens Hospital, Harvard Medical School, Boston, MA; 4Department of Medicine, University of California at San Francisco, San Francisco, CA; 5Heart Institute, Sheba Medical Center, Tel Hashomer, Israel Background The effect of CRT on the risk of ventricular tachyarrhythmias (VTA) is controversial Reverse remodeling LV epicardial pacing VTA and ICD shocks are associated with reduction in quality of life and with poor prognosis MADIT CRT 1820 patients NYHA class I/II LVEF 0.30 QRS 130 msec CRT-D or ICD (3:2 ratio) Mean FU 2.4 years Clinical outcome Death or HF event HR (95% CI) = 0.66 (0.52-0.84) Echocardiographic outcome Objective To explore the association between the magnitude of echocardiographic response to CRT and subsequ