Τίτλος:
Association of QRS narrowing with response to cardiac resynchronization therapy—a systematic review and meta-analysis of observational studies
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Prolonged QRS duration, which reflects a higher degree of mechanical dysynchrony, is a predictor of response to CRT. However, the association of QRS narrowing after biventricular pacing with CRT response rates is not clear. Our aim was to conduct a systematic review and meta-analysis on the association between QRS narrowing after cardiac resynchronization therapy (CRT) and clinical and echocardiographic response to CRT in patients with heart failure. Two independent investigators searched MedLine and EMBASE databases through July 2018 without any limitations. Studies providing estimates (continuous data) on the association of QRS shortening with either clinical (defined as New York Heart Association (NYHA) reduction ≥ 1) or echocardiographic (defined as left ventricular end-systolic volume (LVESV) reduction ≥ 15%) response to CRT were finally included in the quantitative synthesis. We included 32 studies (14 studies (1274 patients mean age 64 years old, males 79.3%) using clinical CRT response and 18 studies (1270 patients, mean age 64 years old, males 69.1%) using echocardiographic CRT response). A significant association between QRS narrowing and shorter attained QRS duration with clinical and echocardiographic CRT response was observed. The observed association was independent of the timing of QRS width measurement after CRT implantation. Acute and late improvement of electrical dysynchrony as depicted by QRS narrowing following biventricular pacing is associated with clinical and echocardiographic response to CRT. However, large prospective studies are needed to further examine our findings. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Bazoukis, G.
Naka, K.K.
Alsheikh-Ali, A.
Tse, G.
Letsas, K.P.
Korantzopoulos, P.
Liu, T.
Yeung, C.
Efremidis, M.
Tsioufis, K.
Baranchuk, A.
Stavrakis, S.
Περιοδικό:
Heart Failure Reviews
Λέξεις-κλειδιά:
cardiac resynchronization therapy; cardiomyopathy; echocardiography; effect size; electrocardiogram; follow up; heart left ventricle endsystolic volume; human; New York Heart Association class; prospective study; QRS interval; QRS narrowing; QRS shortening; quantitative analysis; Review; sample size; scoring system; systematic review; treatment response; cardiac resynchronization therapy; electrocardiography; heart failure; meta analysis; observational study; pathophysiology; procedures, Cardiac Resynchronization Therapy; Electrocardiography; Heart Failure; Humans; Observational Studies as Topic
DOI:
10.1007/s10741-019-09839-5
