PMID- 18651415
OWN - NLM
STAT- MEDLINE
DCOM- 20081021
LR  - 20081129
IS  - 1898-018X (Electronic)
IS  - 1898-018X (Linking)
VI  - 15
IP  - 3
DP  - 2008
TI  - Metaanalysis on effects of cardiac resynchronization therapy in heart failure 
      patients with narrow QRS complex.
PG  - 230-6
AB  - BACKGROUND: To systematically review the benefits of cardiac resynchronization 
      therapy (CRT) in heart failure patients with narrow QRS (< 120 ms) who have 
      baseline mechanical asynchrony. METHODS: We searched the MEDLINE, Cochrane 
      Central Register of Controlled Trials, and reference lists of retrieved articles 
      for relevant trials through October 2007. Studies were included if they were 
      clinical trials in heart failure patients with narrow QRS complex, had at least 3 
      months of duration and measured baseline mechanical dyssynchrony. Weighted mean 
      difference (WMD) for changes in left ventricular ejection fraction (LVEF), New 
      York Heart Association (NYHA) class and 6 minute walk distance (6MWD) at the end 
      of follow up period were estimated using fixed effects meta-analysis. RESULTS: 
      Three relevant clinical trials (enrolling 98 patients) out of 80 identified 
      studies were included in the final analysis. When compared to baseline, CRT in 
      heart failure patients with narrow QRS complex significantly improved mean LVEF 
      (WMD 7.98%, 95% CI 5.94, 10.03) and 6MWD (WMD 67 m, 95% CI 39.12, 94.98) at the 
      end of follow up period with no significant heterogeneity between the included 
      studies (I(2) < 50%). Similarly, there was a significant reduction in NYHA at the 
      end of follow-up (WMD -0.87, 95% CI -1.01, -0.74) but there was significant 
      heterogeneity between the included studies. CONCLUSIONS: In patients with narrow 
      QRS complex and baseline mechanical asynchrony, who underwent CRT after optimal 
      medical management, there was a significant reduction in NYHA class, improvement 
      in LVEF and increase in 6MWD during follow up. Further data from large randomized 
      trials are warranted to explore the role of CRT in heart failure patients with 
      narrow QRS complex.
FAU - Jeevanantham, Vinodh
AU  - Jeevanantham V
AD  - General Internal Medicine, Wake Forest University Health Sciences, Medical Center 
      Blvd, Winston-Salem, NC 27157, USA. vjeevanantham@gmail.com
FAU - Zareba, Wojciech
AU  - Zareba W
FAU - Navaneethan, Sankar
AU  - Navaneethan S
FAU - Fitzgerald, David
AU  - Fitzgerald D
FAU - Yu, Cheuk-Man
AU  - Yu CM
FAU - Achilli, Augusto
AU  - Achilli A
FAU - Bax, Jeroen
AU  - Bax J
FAU - Daubert, James
AU  - Daubert J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - Poland
TA  - Cardiol J
JT  - Cardiology journal
JID - 101392712
SB  - IM
MH  - Aged
MH  - *Cardiac Pacing, Artificial
MH  - Electrocardiography
MH  - Female
MH  - Heart Conduction System
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Treatment Outcome
EDAT- 2008/07/25 09:00
MHDA- 2008/10/22 09:00
CRDT- 2008/07/25 09:00
PHST- 2008/07/25 09:00 [pubmed]
PHST- 2008/10/22 09:00 [medline]
PHST- 2008/07/25 09:00 [entrez]
PST - ppublish
SO  - Cardiol J. 2008;15(3):230-6.