Cardiac Resynchronization Therapy in Patients with Mild Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ronghui Tu , Guoqiang Zhong , Zhiyu Zeng , Weifeng Wu , Hai Wu , Xiaoli Cao , Lynn Htet Htet Aung
- چاپ و سال / کشور: 2011
Description
Objective This review aims at updating the results of cardiac resynchronization therapy (CRT) in mild heart failure patients, and investigating whether CRT can prevent or reverse heart failure progression in an earlier stage. Methods Randomized controlled trials of CRT in patients with New York Heart Association (NYHA) Class I or II heart failure were identified. The effects of CRTon worsening heart failure hospitalization, all-cause mortality, and overall adverse events were meta-analyzed, and the effects of CRTon left ventricular (LV) were systematically reviewed and meta-analyzed. Results Eight studies were identified with a total of 4,302 patients. CRT was associated with a substantial improvement in LVend-systolic volume (WMD -39, 95%CI -41.56 to -36.45). CRT also had a marked effect in reducing new hospitalizations for worsening heart failure by 31% (RR 0.69, 95%CI 0.60 to 0.79). In addition, CRTsignificantly decreased all-cause mortality by 21% (RR 0.79, 95%CI 0.67 to 0.93). However, complications in patients with CRT increased by 74% (RR 1.74, 95%CI 1.44 to 2.11). Conclusions This meta-analysis suggests that CRT could improve the prognosis in patients with mild heart failure and ventricular dyssynchrony, but these improvements are accompanied by more adverse events. Since most patients in the included trials had received ICD therapy, our analysis suggests that CRT could offer an additional benefit.
Cardiovasc Drugs Ther (2011) 25:331–340 Published online: 13 July 2011
