REVERSE Trial Responder Index Calculator
- REVERSE Trial Responder Index: Explanation and Clinical Context
The REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial introduced a multidimensional framework to identify cardiac resynchronization therapy (CRT) responders. It evaluated both structural reverse remodeling—quantified as ≥15% reduction in LVESVi—and clinical improvement—defined by changes in exercise capacity, symptom burden, and quality of life.
In this calculator, the structural response is determined by the relative reduction in LVESVi, while clinical response is based on the combination of improvement in 6-minute walk distance (>25 meters), reduction in Minnesota Living With Heart Failure Questionnaire (MLHFQ) score by ≥5 points, and improvement in NYHA functional class. Patients meeting both domains are classified as complete responders, those meeting one as partial responders, and those meeting none as non-responders.
This multidimensional index enhances CRT evaluation beyond simple echocardiographic remodeling, integrating patient-centered outcomes and functional recovery. The REVERSE trial demonstrated that responders had significantly improved survival, reduced heart failure hospitalizations, and sustained ventricular reverse remodeling at long-term follow-up.
Reference:
Linde C, Abraham WT, Gold MR, et al. Long-term impact of cardiac resynchronization therapy in mild heart failure: 5-year results from the REVERSE study. Eur Heart J. 2013;34(33):2592–2599. doi:10.1093/eurheartj/eht250
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction: results from the REVERSE study. Circulation. 2008;118(12):1159–1167. doi:10.1161/CIRCULATIONAHA.108.772806
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