Redefining CRT Response: A New Perspective from the REVERSE Clinical Trial

April 2, 2021

Dr Nasrien Ibrahim discusses with Dr Michael Gold a new analysis of results from the REVERSE trial, where mild HF patients who received CRT were classified as improved, stabilized, or worsened based upon Clinical Composite Score (CCS) and change in Left Ventricular End Systolic Volume index (LVESVi). The analysis compared 5-year all-cause mortality across the subgroups. The analysis found patients who stabilize with CRT have a much better prognosis than previously appreciated – suggesting that the current classification of “non-responder” is not appropriate. Key findings that will be discussed from this analysis will include:

• Long-term survival is similar among mild HF patients with stabilized and improved statuses.

• 6-month LVESVi is the most important predictor of long-term survival.

• When combining the CCS and LVESVi endpoints, the poorest outcomes were seen in patients who worsened in both measures

• The current classification of CRT ‘response’ does not predict long-term survival; propose to classify CRT outcomes as Improved, Stabilized, or Worsened.

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