Resynchronization therapy in patients with refractory heart failure and myocardial ischemia: long term follow-up
Bibliographic record
Abstract
Cardiac resynchronization therapy (CRT) can be applied in patients with impaired left ventricular (LV) function and advanced heart failure if a reversible cause of a depressed LV function is excluded. We studied 23 patients with an ischemic cardiomyopathy and heart failure class III-IV NYHA and QRS duration > 120 msec who were rejected for surgical and percutaneous interventions. In 14 patients revascularisation was not amenable for technical reasons, 7 had extensive co-morbidity and 2 refused a (repeated) surgical intervention. All had documented myocardial ischemia on nuclear or echocardiographic stress studies. In all successful implantation was performed and follow-up was 13±1.9 months. Nine patients had two-vessel disease and 14 patients had three-vessel disease on coronary angiography. Seven patients had previous myocardial infarction. Mean LV ejection fraction was 23±4 %. During follow-up 4 patients died: 3 patients had sudden death while 1 patient died 2 days after (recurrent) myocardial infarction. In the remaining group functional class improved from 3.2±1.4 to 2.0±1.0, p< 0.01. Quality-of-life assessed by the Minnesota Living with Heart Failure questionnaire improved from 39±15 to 28±13, p< 0.01. The 6-minutes walking test increased from 264±104 to 385±121(m), p<0.01). Despite an improvement in exercise capacity anginal attacks/week remained the same (2.3±0.7 to 2.2±0.6, p=ns). In patients with advanced heart failure, stable angina and documented myocardial ischemia CRT can be performed safely with good long term follow-up.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".