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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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The importance of myocardial contractile reserve in predicting response to cardiac resynchronization therapy

Mariëlle Kloosterman1, Kevin Damman1, Dirk J Van Veldhuisen1

  • 1Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, the Netherlands.

European Journal of Heart Failure
|February 25, 2017
PubMed

Insights

Contractile reserve predicts a better response to cardiac resynchronization therapy (CRT) in heart failure patients. This finding suggests contractile reserve is a valuable biomarker for CRT success.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Medical Biomarkers

Background:

  • Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
  • Predicting CRT response remains a clinical challenge.
  • Contractile reserve may indicate patient suitability for CRT.

Purpose of the Study:

  • To systematically review and meta-analyze data on the relationship between contractile reserve and CRT response.
  • To assess if contractile reserve is a predictor of successful CRT.

Main Methods:

  • Systematic review and meta-analysis of published observational studies.
  • Searched MEDLINE/PubMed and Cochrane databases up to April 2016.
  • Included 9 studies with 767 patients; 757 provided data for analysis.

Main Results:

  • Contractile reserve was present in 66% of patients.
  • 63% of patients were identified as CRT responders.
  • Patients with contractile reserve had a significantly higher likelihood of CRT response (OR 4.42, P < 0.001).
  • After accounting for publication bias, the association remained significant (OR 2.42, P = 0.018).

Conclusions:

  • Baseline contractile reserve, assessed by dobutamine stress echocardiography, is associated with an increased likelihood of CRT response in heart failure patients.
  • Contractile reserve serves as a potential biomarker for predicting CRT outcomes.
Abstract

Keywords:
DobutamineDyssynchronyHeart failureMyocardial viabilityReverse remodellingStress echocardiography

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