Long term biventricular resynchronisation therapy in advanced heart failure: effect on neurohormones

Objective: To assess prospectively the effect of cardiac resynchronisation therapy (CRT) on New York Heart Association (NYHA) functional class, cardiac function, cardiopulmonary exercise performance, and neurohormonal activation during 24 months’ follow up. Design: Controlled study. Patients and Results: 124 patients with severe congestive heart failure (ejection fraction 150 ms) were enrolled (control group, n  =  59; CRT group, n  =  65) and followed up at 1, 3, 12, and 24 months. Compared with the control group, CRT led to significant short and long term improvements in functional NYHA functional class (mean (SEM) 2.1 (0.4) v 2.8 (0.4) at 24 months, p v 21.1 (5)% at 24 months, p 2 (16.8 (3.9) v 12.6 (3.5) ml/kg × min at 24 months, p 2 at anaerobic threshold (14.4 (3.7) v 10.8 (3.2) ml/kg × min at 24 months, p Conclusion: Long term CRT (⩽ 24 months) results in significant improvement of NYHA class and cardiopulmonary exercise capacity and a short term decrease in neurohormonal activation.