Abstract 14810: Relationship of Baseline Right Ventricular Function With Response to Cardiac Resynchronization Therapy
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 (LV) size and function in patients with markedly abnormal ECG QRS duration. However, relationship of baseline RV function with response to CRT has not been well described.
Objective: To investigate the relationship of baseline RV function with response to CRT as assessed by change in LV ejection fraction (LVEF).
Methods: A systematic search of studies published between 1966 to February 2015 was conducted using Pub Med, CINAHL, Cochrane CENTRAL and the Web of Science databases. Studies were included if they have reported a) parameters of baseline RV function [tricuspid annular plane systolic excursion (TAPSE) or RV ejection fraction (RVEF) or RV basal strain or RV fractional area change (FAC)] and b) LVEF before and after CRT. Random-effects meta-regression was used to evaluate the effect of baseline RV function parameters and change in LVEF.
Results: Sixteen studies (N=1764) were selected for final analysis. Random-effects meta-regression analysis showed no significant association between the magnitude of the difference in EF pre and post CRT with baseline TAPSE (beta 0.005, p 0.989); baseline RVEF (beta 0.270, p 0.493); baseline RVFAC (beta - 0.367, p 0.06); baseline basal strain (beta -0.342, p= 0.462) after a mean follow up period of 10.5 months
Conclusion: Baseline RV function as assessed by TAPSE, FAC, basal strain or RVEF, does not determine response to CRT as assessed by change in LVEF. Future studies should assess the relationship of baseline RV function with response to CRT in terms of improvement in symptoms, quality of life and major HF morbidity and mortality.
Author Disclosures: A. Sharma: None. A. Vallakati: None. S. Goel: None. C. Lavie: None. J. Kassotis: None. N. Warrier: None. D. Mukherjee: None. J. Lazar: None. A.J. Einstein: None.
- © 2015 by American Heart Association, Inc.