Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis
Ibadete Bytyçi1,2, Gani Bajraktari1,2, Per Lindqvist1,3
1Institute of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden.
Journal of Clinical Medicine
|January 25, 2020
Summary
Cardiac resynchronization therapy (CRT) improves left atrial (LA) function in responders, indicating reverse LA remodeling. This improvement correlates with beneficial changes in left ventricular (LV) size and function.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Medical Imaging
Background:
- Cardiac resynchronization therapy (CRT) is a treatment for heart failure that can lead to reverse left atrial (LA) remodeling.
- Understanding the impact of CRT on LA function is crucial for assessing treatment response and patient outcomes.
Purpose of the Study:
- To evaluate the relationship between clinical response to CRT and changes in LA function using a meta-analysis.
- To determine if improvements in LA function correlate with reverse remodeling of the left ventricle (LV).
Main Methods:
- Systematic literature search of electronic databases up to September 2019.
- Meta-analysis of seven studies including 488 patients undergoing CRT.
- Assessment of LA systolic strain and emptying fraction (EF) in CRT responders versus non-responders at 6-month follow-up.
Main Results:
- CRT responders showed significantly increased LA systolic strain and LA emptying fraction (EF) compared to non-responders.
- Improvements in LA strain and EF were strongly correlated with a decrease in LV end-systolic volume (LVESV) and an increase in LV ejection fraction (LVEF).
- Increased LA strain also correlated with increased LA EF, suggesting coordinated functional improvements.
Conclusions:
- Improved LA function in CRT responders signifies reverse LA remodeling.
- The observed LA functional improvements are intrinsically linked to concurrent beneficial changes in LV remodeling and function.
- LA function assessment may serve as a valuable indicator of CRT treatment efficacy.
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