Document Detail


Metaanalysis on effects of cardiac resynchronization therapy in heart failure patients with narrow QRS complex.
MedLine Citation:
PMID:  18651415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To systematically review the benefits of cardiac resynchronization therapy (CRT) in heart failure patients with narrow QRS (< 120 ms) who have baseline mechanical asynchrony. METHODS: We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and reference lists of retrieved articles for relevant trials through October 2007. Studies were included if they were clinical trials in heart failure patients with narrow QRS complex, had at least 3 months of duration and measured baseline mechanical dyssynchrony. Weighted mean difference (WMD) for changes in left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class and 6 minute walk distance (6MWD) at the end of follow up period were estimated using fixed effects meta-analysis. RESULTS: Three relevant clinical trials (enrolling 98 patients) out of 80 identified studies were included in the final analysis. When compared to baseline, CRT in heart failure patients with narrow QRS complex significantly improved mean LVEF (WMD 7.98%, 95% CI 5.94, 10.03) and 6MWD (WMD 67 m, 95% CI 39.12, 94.98) at the end of follow up period with no significant heterogeneity between the included studies (I(2) < 50%). Similarly, there was a significant reduction in NYHA at the end of follow-up (WMD -0.87, 95% CI -1.01, -0.74) but there was significant heterogeneity between the included studies. CONCLUSIONS: In patients with narrow QRS complex and baseline mechanical asynchrony, who underwent CRT after optimal medical management, there was a significant reduction in NYHA class, improvement in LVEF and increase in 6MWD during follow up. Further data from large randomized trials are warranted to explore the role of CRT in heart failure patients with narrow QRS complex.
Authors:
Vinodh Jeevanantham; Wojciech Zareba; Sankar Navaneethan; David Fitzgerald; Cheuk-Man Yu; Augusto Achilli; Jeroen Bax; James Daubert
Related Documents :
10595975 - Cardiac operations in patients with low-grade small lymphocytic malignancies.
16575475 - Cardiac function and cardiopulmonary performance in patients after treatment for non-ho...
7733765 - Selection and clinical significance of neuropsychologic tests.
18308015 - Reverse of left ventricular volumetric and structural remodeling in heart failure patie...
23043755 - Use of a sealant to prevent prolonged air leaks after lung resection: a prospective ran...
23588825 - Functional repair in massive immobile rotator cuff tears leads to satisfactory quality ...
Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Cardiology journal     Volume:  15     ISSN:  1897-5593     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-24     Completed Date:  2008-10-21     Revised Date:  2008-11-29    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  230-6     Citation Subset:  IM    
Affiliation:
General Internal Medicine, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27157, USA. vjeevanantham@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial*
Electrocardiography
Female
Heart Conduction System
Heart Failure / therapy*
Humans
Male
Middle Aged
Severity of Illness Index
Stroke Volume
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Outcome of patients with stable angina pectoris treated with or without percutaneous coronary interv...
Next Document:  Prognostic significance of submaximal negative dobutamine stress echocardiography: a 3-year follow-u...