Background: Impairment of myocardial mechano-energetic efficiency (MEE) is present in virtually all patients with heart failure with reduced ejection fraction (HFrEF). Cardiac contractility modulation (CCM) improves the quality of life and functional capacity, reduces hospitalizations, and induces biventricular reverse remodeling in patients with HFrEF. However, the effects of this innovative therapy on mechano-energetics efficiency and global longitudinal strain (GLS) are still unknown; therefore, the aim of this study is to evaluate whether CCM therapy can improve the MEE of patients with HFrEF.
Methods: We enrolled 25 patients with HFrEF who received an Optimizer Smart implant (the device that develops CCM therapy) between January 2018 and January 2021. Clinical and echocardiographic data were obtained from all patients 24 hours before and six months after CCM therapy.
Results: At six months, follow-up patients who underwent CCM therapy showed an increase of left ventricular ejection fraction (30.8+7.1 vs. 36.1+6.9%; p = 0.032) as well a rise of GLS 10.3+2.7 vs.-12.9+4.2; p = 0.018), of MME (32.2 + 10.1 vs. 38.6 + 7.6 mL/s; p = 0.013) and of MEE index (18.4 + 6.3 vs 24.3 + 6.7 mL/s/g; p = 0.022).
Conclusions: CCM therapy increased left ventricular performance, improving left ventricular ejection fraction, GLS, as well as MEE and MEEi.