title: Meta-Analysis of the Relation of Baseline Right Ventricular Function to Response to Cardiac Resynchronization Therapy.
abstract: 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 electrocardiogram QRS duration. However, relation of baseline RV function with response to CRT has not been well described. In this study, we aim to investigate the relation of baseline RV function with response to CRT as assessed by change in LV ejection fraction (EF). A systematic search of studies published from 1966 to May 31, 2015 was conducted using PubMed, CINAHL, Cochrane CENTRAL, and the Web of Science databases. Studies were included if they have reported (1) parameters of baseline RV function (tricuspid annular plane systolic excursion [TAPSE] or RVEF or RV basal strain or RV fractional area change [FAC]) and (2) LVEF before and after CRT. Random-effects metaregression was used to evaluate the effect of baseline RV function parameters and change in LVEF. Sixteen studies (n = 1,764) were selected for final analysis. Random-effects metaregression analysis showed no significant association between the magnitude of the difference in EF before and after CRT with baseline TAPSE (β = 0.005, p = 0.989); baseline RVEF (β = 0.270, p = 0.493); baseline RVFAC (β = -0.367, p = 0.06); baseline basal strain (β = -0.342, p = 0.462) after a mean follow-up period of 10.5 months. In 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.
authors.affiliation: Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, New York, New York. Electronic address: abhisheksharma4mamc@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jerome J
authors.initials: JJ
authors.lastname: Bax
authors.affiliation: Division of Cardiology, Metrohealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Ajay
authors.initials: A
authors.lastname: Vallakati
authors.affiliation: Department of Medicine, Maimonides Medical Center, New York, New York.
authors.forename: Sunny
authors.initials: S
authors.lastname: Goel
authors.affiliation: Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, New York, New York.
authors.forename: John
authors.initials: J
authors.lastname: Kassotis
authors.affiliation: Division of Cardiology, Texas Tech University, El Paso, Texas.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York; Division of Cardiology, Department of Radiology, Columbia University Medical Center, New York, New York.
authors.forename: Andrew
authors.initials: A
authors.lastname: Einstein
authors.affiliation: Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, New York, New York.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Warrier
authors.affiliation: Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, New York, New York.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lazar
mesh_terms: D058406:Cardiac Resynchronization Therapy; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D016278:Ventricular Function, Right / Q000502:physiology*