Th and other regulatory bodies concluded that standards for weighting composite scores were needed; that consensus was needed to define a clinically meaningful effect of composite scores, and that the value of the ‘trade-off’ position between components of composite scores needs to be defined. 83 these issues are yet to be addressed in the field of crt. Arguably, they should be a priority for regulatory bodies. buy viagra cheap Previous section next section conclusions in summary, crt has revolutionized the treatment of selected patients with heart failure. Although reverse lv remodelling is a promising surrogate of outcome after crt, one should consider that volumetric ‘non-responders’ may nevertheless experience symptomatic benefit. generic viagra names jokes On the other hand, patients who benefit symptomatically may not necessarily derive a prognostic benefit. As for most heart failure therapies, reliable measures of response to crt in individual patients are yet to emerge. Composite measures may hold the key. Such measures must be validated against the survival and symptomatic benefits that are to be expected from therapy in individual patients, on the basis of randomized, controlled trials. In addition, composite clinical endpoints must reflect the relative importance of response and outcome benefits, as judged by patients, not doctors. viagra online Until this is established, the terms ‘responder’ and ‘non-responder’ to crt have little meaning in clinical practice. Conflict of interest: none declared. Previous section next section funding the open access publication charges for this article were paid for from research funds provided by the heart of england nhs foundation trust. cheap viagra india Published on behalf of the european society of cardiology. generic viagra online All rights reserved. â© the author 2009. funciona viagra yahoo respuestas For permissions please email: journals. Permissions@oxfordjournals. Org. viagra canada online Previous section â  references ↵ cazeau s , ritter p , bachdach s , lazarus a , limousin m , henao l , et al. Four chamber pacing in dilated cardiomyopathy. Pacing clin electrophysiol 1994;17:1974-9. viagra for sale Crossref medline ↵ leclercq c , cazeau s , le breton h , ritter p , mabo p , gras d , et al. Acute hemodynamic effects of biventricular ddd pacing in patients with end stage heart failure. J am coll cardiol 1998;32:1825-31. Abstract / free full text ↵ auricchio a , stellbrink c , block m , sack s , vogt j , bakker p , et al. ; for the guidant congestive heart failure research group. Effect of pacing chamber and at. happens women use viagra