{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:12:49Z","timestamp":1762917169499},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":3200,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2000,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background and hypothesis:<\/jats:italic> Although medical therapy may normalize echocardiographic left ventricular (LV) systolic function in selected patients with cardiomyopathy, other patients experience no change or a further deterioration in heart failure remodeling. Our aim was to determine what clinical or echocardiographic parameters predict a beneficial therapeutic response.<\/jats:p><jats:p><jats:italic>Methods:<\/jats:italic> We prospectively followed biannual clinical and echocardiographic assessments in 215 patients. Forty\u2010six of these patients (\u201cNonresponders\u201d) experienced no change or a decline in LV ejection fraction at 6 months. Of the 148 patients who improved LV function, 21 (\u201cResponders\u201d) normalized LV systolic function at 6 months. Only Responders (n = 21) and Nonresponders (n = 46) were compared.<\/jats:p><jats:p><jats:italic>Results:<\/jats:italic> On average, these 67 patients were 54 \u00b1 12 years old with 4.5 \u00b1 3.3 years of heart failure. At 6 months, following uptitration of angiotensin\u2010converting enzyme inhibitors and nitrates, Responder LV ejection fraction rose from 22 \u00b1 6 to 50 \u00b1 5% with improvement in New York Heart Association classification (2.6 \u00b1 0.8 to 1.5 \u00b1 0.8, p = 0.001). These patients had significantly more favorable clinical and echocardiographic outcomes versus Nonresponders despite comparable medical therapy. All baseline demographic, clinical, and echocardiographic variables were equivalent, except for initial LV end\u2010diastolic diameter which differentiated Nonresponders (7.1 \u00b1 0.7 cm) from Responders (6.1 \u00b1 0.8 cm), p = 0.007.<\/jats:p><jats:p><jats:italic>Conclusion:<\/jats:italic> Thus, although heart failure therapy improves LV systolic function in a majority of patients, with normalization in up to 10% of patients, significant LV enlargement may render remodeling unresponsive to pharmacologic intervention, with a potential future need for alternative mechanical or surgical intervention.<\/jats:p>","DOI":"10.1002\/clc.4960230510","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T04:43:12Z","timestamp":1233722592000},"page":"355-358","source":"Crossref","is-referenced-by-count":12,"title":["Impact of left ventricular size on pharmacologic reverse remodeling in heart failure"],"prefix":"10.1002","volume":"23","author":[{"given":"T.","family":"Barry Levine","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene B.","family":"Levine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Bolenbaug","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Stomel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.10.2504"},{"key":"e_1_2_1_3_2","doi-asserted-by":"crossref","unstructured":"SabbahHN KonoT SteinPD ManciniJ GoldsteinS:Left ventricular shape changes during the course of evolving heart failure.Am J Physiol263 (Heart Circ Physiol32 )1992;H266\u2013H270","DOI":"10.1152\/ajpheart.1992.263.1.H266"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706043162301"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250502"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250501"},{"key":"e_1_2_1_7_2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1056\/NEJM199209033271003","article-title":"Effect of enalapril on mortality and the development of heart failure in symptomatic patients with reduced left ventricular ejection fractions","volume":"327","author":"The SOLVD Investigators","year":"1992","journal-title":"N Engl J Med"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.2.431"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.10.2573"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92930-R"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00012-S"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.82.2.473"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00543-Y"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960200806"},{"key":"e_1_2_1_15_2","unstructured":"LevineTB LevineAB KeteyianSJ KlineDA:Response of ischemic versus nonischemic cardiomyopathy with intensification of vasodilator therapy.Cong Heart Failure1998;Mar\/Apr:15\u201322"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(98)00123-X"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00623-7"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.4960230510","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.4960230510","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T12:22:01Z","timestamp":1698582121000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.4960230510"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,5]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2000,5]]}},"alternative-id":["10.1002\/clc.4960230510"],"URL":"https:\/\/doi.org\/10.1002\/clc.4960230510","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,5]]}}}