Heart failure & cardiomyopathies
Cardiac Resynchronization Therapy in Inotrope-Dependent Heart Failure: A Meta-Analysis
Authors' conclusion
CRT appears to be a viable option for inotrope-dependent HF, with some of these patients seeming more likely to respond.
Study context
- Population
- Adults (≥18 years) with inotrope-dependent heart failure (HF) requiring inotropic support at cardiac resynchronization therapy (CRT) implantation
- Participants
- 386 adults19 studies
- Outcome
- Survival to discharge, weaning off inotropes and discharge time post-CRT
Methodological detailsMedline, EMBASE, Scopus and Cochrane Library searched until 31 December 2022
- Medline, EMBASE, Scopus and Cochrane Library searched until 31 December 2022
Pooled result
As reported in the abstract
| Group | Survival to discharge | Weaned off inotropes | Mean discharge time post-CRT |
|---|---|---|---|
| CRT | 91.1% [95% CI: 81.2% to 97.6%] | 89.3% (95% CI: 77.6% to 97.0%) | 7.8 days (95% CI: 3.9 to 11.7) |
CRT
Survival to discharge91.1% [95% CI: 81.2% to 97.6%]
Weaned off inotropes89.3% (95% CI: 77.6% to 97.0%)
Mean discharge time post-CRT7.8 days (95% CI: 3.9 to 11.7)
Further pooled results
| Outcome | Values |
|---|---|
| NYHA class post-CRT | CRT mean 2.7 (95% CI 2.5–3.0) |
- New York Heart Association (NYHA) class post-CRT — Reduction of individuals in NYHA IV: RR 0.27 (95% CI: 0.18 to 0.41)
- P < 0.00001
Mean number of HF hospitalisations during follow-up
- Mean number of HF hospitalisations reduced by 1.87 (95% CI: 1.04 to 2.70)
- P < 0.00001
QRS duration post-CRT
- Post-CRT mean QRS duration reduced by 29.0 ms (95% CI: −41.3 to 16.7)
- P < 0.00001
LVEF
- Mean LVEF increased by 4.8% (95% CI: 3.1% to 6.6%)
- P < 0.00001
Characteristics associated with response (univariate analysis)
- Male
- 85.7% vs. 40%
- History of left bundle branch block
- 71.4% vs. 30%
- LV end-diastolic dilation
- 274.3 ± 7.2 vs. 225.9 ± 6.1 mL
- Univariate analysis
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Cardiac Resynchronization Therapy in Inotrope-Dependent Heart Failure: A Meta-Analysis. ESC Heart Fail. Published 6 May 2024. doi:10.
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