Role of Cardiac Contractility Modulation in Heart Failure With a Higher Ejection Fraction |
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| Affiliation: | 1. Department of Medicine, University of Mississippi Medical Centre, Jackson, Mississippi, USA;2. Department of Cardiology and Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany;3. DZHK (German Center for Cardiovascular Research) Berlin partner site, Charité Universitätsmedizin Berlin, Germany;4. Cardiovascular Research Foundation, New York, New York, USA;5. National and Kapodistrian University of Athens, School of Medicine, Athens, Greece;6. National Heart Centre Singapore and Duke-National University of Singapore, Singapore;7. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA;8. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA;9. Baylor Heart and Vascular Institute, Baylor University Medical Centre, Dallas, Texas, USA |
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| Abstract: | Cardiac contractility modulation (also known as CCM) is a novel device therapy that delivers nonexcitatory electric stimulation to cardiac myocytes during the absolute refractory period, and it has been shown to improve functional status and clinical outcomes in patients with heart failure (HF) with reduced ejection fraction (HFrEF). CCM therapy is currently recommended for a subset of patients with advanced HFrEF who are not candidates for cardiac resynchronization therapy. A growing body of evidence demonstrates the benefit of CCM therapy in patients with HFrEF and with ejection fraction at the upper end of the spectrum and in patients with HF and with mildly reduced ejection fraction (HFmrEF). Experimental studies have also observed reversal of pathological biomolecular intracellular changes with CCM therapy in HF with preserved ejection fraction (HFpEF), indicating the potential for clinically meaningful benefits of CCM therapy in these patients. In this review, we sought to discuss the basis of CCM therapy and its potential for management of patients with HF with higher ejection fractions. |
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