Cardiac contractility modulation therapy promising for patients with HFpEF

A pilot study assessing cardiac contractility modulation (CCM) therapy in patients with heart failure (HF) with preserved ejection fraction (HFpEF) displayed a significant improvement in the health status of patients. Further studies are warranted to establish the applicability of CCM in patients with HFpEF.

“CCM therapy has been demonstrated to be efficacious in patients with HF with reduced or mid-range ejection fractions,” mentioned Prof. Cecilia Linde (Karolinska University Hospital, Sweden) [1]. The current prospective, multicentre CCM-HFpEF pilot study (NCT03240237) aimed to assess the efficacy and safety of CCM in patients with symptomatic HFpEF (n=47). The primary efficacy endpoint was the mean change in Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary score through week 24 and the primary safety endpoint was the number of device-related and procedure-related complications.

After 24 weeks, CCM therapy was associated with a mean improvement of 18.0 points on the KCCQ overall summary score (P<0.001). Similarly, the mean change in KCCQ clinical summary score from baseline was 15.3 points (P<0.001). Left atrial volume index was decreased (48.2 mL/m² vs 45.9 mL/m²; P=0.034), as was the septal E/e’ ratio (15.3 vs 14.5; P=0.038), and the New York Heart Association (NYHA) class (2.6 vs 2.2; P<0.001). In addition, only 2 participants had experienced ≥1 HF hospitalisation during the study (168 days) compared with 15 participants in the year before CCM was administered. As for safety, 3 procedure-related complications were reported in 3 participants and no device-related complications were observed after 24 weeks, resulting in an event-free rate of 93.6%.

“To date, there has not been a device to improve the quality-of-life of patients with HFpEF,” commented Prof. Wilfried Mullens (Hospital Oost-Limburg, Belgium). “The current study is important since it displayed an impressive improvement in the KCCQ score in patients with HFpEF who were treated with CCM. However, the results of this pivotal study need to be confirmed in large randomised trials.”

1. Linde C, et al. CCMHFpEF: Is CCM Therapy safe and effective in patients with HFpEF? LBT Devices, Heart Failure 2022, 21–24 May, Madrid, Spain.

 

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Posted on 28 July 202231 January 2024