Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis
Cardiac resynchronization therapy (CRT) is associated with reverse left atrial (LA) remodeling. The aim of this meta-analysis was to assess the relationship between clinical response to CRT and LA function changes. We conducted a systematic search of all electronic databases up to September 2019 whi...
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doaj-031a6e4d6931459483b3f7ecf09799092020-11-25T02:05:26ZengMDPI AGJournal of Clinical Medicine2077-03832020-01-019229810.3390/jcm9020298jcm9020298Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-AnalysisIbadete Bytyçi0Gani Bajraktari1Per Lindqvist2Michael Y. Henein3Institute of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, SwedenInstitute of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, SwedenInstitute of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, SwedenInstitute of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, SwedenCardiac resynchronization therapy (CRT) is associated with reverse left atrial (LA) remodeling. The aim of this meta-analysis was to assess the relationship between clinical response to CRT and LA function changes. We conducted a systematic search of all electronic databases up to September 2019 which identified 488 patients from seven studies. At (mean) 6 months follow-up, LA systolic strain and emptying fraction (EF) were increased in CRT responders, with a −5.70% weighted mean difference (WMD) [95% confidence interval (CI) −8.37 to −3.04, <i>p</i> < 0.001 and a WMD of −8.98% [CI −15.1 to −2.84, <i>p</i> = 0.004], compared to non-responders. The increase in LA strain was associated with a fall in left ventricle (LV) end-systolic volume (LVESV) <i>r</i> = −0.56 (CI −0.68 to −0.40, <i>p</i> < 0.001) and an increase in the LV ejection fraction (LVEF) <i>r</i> = 0.58 (CI 0.42 to 0.69, <i>p</i> < 0.001). The increase in LA EF correlated with the fall in LVESV <i>r</i> = −0.51 (CI −0.63 to −0.36, <i>p</i> < 0.001) and the increase in the LVEF <i>r</i> = 0.48 (CI 0.33 to 0.61, <i>p</i> = 0.002). The increase in LA strain correlated with the increase in the LA EF, <i>r</i> = 0.57 (CI 0.43 to 0.70, <i>p</i> < 0.001). Thus, the improvement of LA function in CRT responders reflects LA reverse remodeling and is related to its ventricular counterpart.https://www.mdpi.com/2077-0383/9/2/298left atrial straincardiac resynchronization therapyheart failure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ibadete Bytyçi Gani Bajraktari Per Lindqvist Michael Y. Henein |
spellingShingle |
Ibadete Bytyçi Gani Bajraktari Per Lindqvist Michael Y. Henein Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis Journal of Clinical Medicine left atrial strain cardiac resynchronization therapy heart failure |
author_facet |
Ibadete Bytyçi Gani Bajraktari Per Lindqvist Michael Y. Henein |
author_sort |
Ibadete Bytyçi |
title |
Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis |
title_short |
Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis |
title_full |
Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis |
title_fullStr |
Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis |
title_full_unstemmed |
Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis |
title_sort |
improved left atrial function in crt responders: a systematic review and meta-analysis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-01-01 |
description |
Cardiac resynchronization therapy (CRT) is associated with reverse left atrial (LA) remodeling. The aim of this meta-analysis was to assess the relationship between clinical response to CRT and LA function changes. We conducted a systematic search of all electronic databases up to September 2019 which identified 488 patients from seven studies. At (mean) 6 months follow-up, LA systolic strain and emptying fraction (EF) were increased in CRT responders, with a −5.70% weighted mean difference (WMD) [95% confidence interval (CI) −8.37 to −3.04, <i>p</i> < 0.001 and a WMD of −8.98% [CI −15.1 to −2.84, <i>p</i> = 0.004], compared to non-responders. The increase in LA strain was associated with a fall in left ventricle (LV) end-systolic volume (LVESV) <i>r</i> = −0.56 (CI −0.68 to −0.40, <i>p</i> < 0.001) and an increase in the LV ejection fraction (LVEF) <i>r</i> = 0.58 (CI 0.42 to 0.69, <i>p</i> < 0.001). The increase in LA EF correlated with the fall in LVESV <i>r</i> = −0.51 (CI −0.63 to −0.36, <i>p</i> < 0.001) and the increase in the LVEF <i>r</i> = 0.48 (CI 0.33 to 0.61, <i>p</i> = 0.002). The increase in LA strain correlated with the increase in the LA EF, <i>r</i> = 0.57 (CI 0.43 to 0.70, <i>p</i> < 0.001). Thus, the improvement of LA function in CRT responders reflects LA reverse remodeling and is related to its ventricular counterpart. |
topic |
left atrial strain cardiac resynchronization therapy heart failure |
url |
https://www.mdpi.com/2077-0383/9/2/298 |
work_keys_str_mv |
AT ibadetebytyci improvedleftatrialfunctionincrtrespondersasystematicreviewandmetaanalysis AT ganibajraktari improvedleftatrialfunctionincrtrespondersasystematicreviewandmetaanalysis AT perlindqvist improvedleftatrialfunctionincrtrespondersasystematicreviewandmetaanalysis AT michaelyhenein improvedleftatrialfunctionincrtrespondersasystematicreviewandmetaanalysis |
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