Changes in parameters of right ventricular function with cardiac resynchronization therapy.
Abhishek Sharma1,2, Carl J Lavie3, Ajay Vallakati4
1Division of Cardiovascular Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York.
Clinical Cardiology
|September 13, 2017
Summary
Cardiac resynchronization therapy (CRT) improves right ventricle (RV) function in heart failure patients. However, these improvements are dependent on patient-specific factors like age and QRS duration, not independent of baseline variables.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) is used to treat heart failure (HF).
- Previous studies indicated CRT improves right ventricle (RV) size and function in HF patients.
- The impact of CRT on RV function independent of baseline clinical variables requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of CRT on RV function.
- To determine if RV function improvements with CRT are independent of baseline clinical variables.
Main Methods:
- Systematic literature search of studies from 1966 to August 2015.
- Included studies reporting RV function parameters (TAPSE, FAC, strain, diameters) before and after CRT.
- Performed meta-analysis and meta-regression to assess CRT's impact and its independence from covariates (age, QRS duration, LVEF).
Main Results:
- Analyzed 13 studies with 1541 patients.
- CRT showed significant improvements in TAPSE, RV FAC, basal strain, and RV dimensions.
- Meta-regression revealed that improvements in RV function were dependent on age, QRS duration, and baseline LVEF.
Conclusions:
- CRT significantly improves various echocardiographic parameters of RV function.
- These improvements are not independent of baseline clinical variables.
- RV function enhancement with CRT is statistically linked to patient age, QRS duration, and baseline LVEF.
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