Abstract: In heart failure (HF) patients diagnosed according to the New York Heart Association (NYHA) rating scale as either Class III or Class IV, with QRS duration ?120 ms, left ventricular (LV) EF?35% (when in sinus rhythm), cardiac resynchronization therapy (CRT) can predict sustained improvement in at least LV structure and function. The knowledge of aetiology of a subject's HF status and of a few simple echocardiographic characteristics provides useful information as to whether such patients and undergo significant and beneficial reverse remodelling of the LV in particular and, in the long term can be expected to experience an improvement in all-cause mortality, for example such patients can be reasonably expected to survive and enjoy a relatively enhanced quality of life (QOL). A patient who qualifies according to the invention can be termed a reverse remodelling responder (RRR) or the like.

Abstract: A hand tool comprising first and second jaw members and first and second handle members, the first handle and both jaw members being cooperatively connected by a force multiplying linkage system. A force applied to the first handle drives the linkage system to close the jaws to crimp or cut a work piece. In one embodiment of the invention, a link in the linkage system has a first end movable between first and second positions relative to its first end pivot pin wherein the first and second jaw members close a first distance when the link first end is in the first position and close a second distance when the link first end is in the second position. Other embodiments comprise other step-wise changes in distance between force-bearing pivot locations in the linkage system to close the jaws progressive distances with successive closures of the first and second handles.