Abstract 14707: Effect of Cardiac Resynchronization Therapy (CRT) on Right Ventricular (RV) Function
Background: Right ventricular (RV) dysfunction has been associated with adverse clinical outcomes in patients with heart failure (HF). Cardiac resynchronization therapy (CRT) improves left ventricular size and function in patients with markedly abnormal ECG QRS duration. However, the effect of CRT on RV function has not been well described.
Objective: To evaluate change in RV function after CRT.
Methods: A systematic search of studies published between 1966 to May 2014 was conducted using Pub Med, CINAHL, Cochrane CENTRAL and the Web of Science databases. Studies reporting tricuspid annular plane systolic excursion (TAPSE) or RV basal strain or RV long axis diameter or RV short axis diameter or RV fractional area change (FAC) before and after CRT were identified. A meta-analysis was performed using random effects with inverse variance method to determine the change in various parameters of RV function after CRT therapy.
Results: Twelve studies (N=1478) were selected for final analysis. CRT therapy led to statistically significant increase in TAPSE [1.32(95% CI 0.67 -1.96; p<0.001)], RV FAC [2.88 (95% CI 0.94; 4.83; p=0.004)] and basal strain [2.03(95% CI 0.81-3.26; p=0.001)] and statistically significant decrease in mean RV long axis [-2.95 (95% CI -5.07; -0.83; p=0.01)] and short axis [- 1.39 (95% CI -2.11; -0.67; p<0.001)] after a mean follow up period of 8.7 months.
Conclusion: CRT resulted in improved RV size and function as measured by TAPSE, RV FAC, RV basal strain, RV long axis and short axis diameters. Future studies should assess the impact of these changes on symptoms, quality of life and major HF morbidity and mortality.
Author Disclosures: A. Sharma: None. C.J. Lavie: None. A. Vallakati: None. S. Goel: None. D. Mukherjee: None. E. Lichstein: None.
- © 2014 by American Heart Association, Inc.