PMID- 28453545
OWN - NLM
STAT- MEDLINE
DCOM- 20170907
LR  - 20181202
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - The impact of gender difference on clinical and echocardiographic outcomes in 
      patients with heart failure after cardiac resynchronization therapy: A systematic 
      review and meta-analysis.
PG  - e0176248
LID - 10.1371/journal.pone.0176248 [doi]
LID - e0176248
AB  - BACKGROUND: Cardiac resynchronization therapy(CRT) has been recommended as a 
      standard treatment for patients with advanced heart failure. However, some 
      studies have reported different clinical and echocardiographic outcomes between 
      male and female patients who received CRT. This Meta-analysis is to determine 
      whether gender difference has any significant impact on clinical and 
      echocardiographic outcomes in patients with heart failure after CRT. METHODS AND 
      RESULTS: PubMed, Embase, and the Cochrane library database were searched. A total 
      of 149,259 patients in 11 studies were identified. Our analysis demonstrated that 
      women showed lower all-cause mortality than men after CRT (odds ratio[OR] 0.50, 
      95% confidence interval [CI] 0.36 to 0.70). No significant difference was 
      observed in the increment of New York Heart Association (NYHA) functional 
      class(standard mean difference[SMD] -0.07,95% CI -0.15 to 0.01), 6-minitue walk 
      distance (6-MWD) (SMD -0.05, 95% CI -0.07 to 0.17), and quality of life (QoL) 
      (SMD -0.10, 95% CI -0.23 to 0.03). With respect to the echocardiographic 
      parameters, women exhibited statistically significant improvement in left 
      ventricular ejection fraction (LVEF) (SMD 0.25,95% CI 0.07 to 0.43), and 
      decrement of left ventricular end diastolic diameter (LVEDD) (SMD -0.27, 95% CI 
      -0.39 to -0.25) as compared with men. No significant difference was observed in 
      left ventricular end diastolic volume (LVEDV) (SMD -0.08, 95% CI -0.28 to 0.08) 
      and left ventricular end systolic volume (LVESV) (SMD -0.16, 95% CI -0.40 to 
      0.09) between men and women. CONCLUSION: Women seem to obtain greater benefits 
      from CRT both in clinical and echocardiographic outcomes compared with men. But 
      as this gender superiority could be observed only during long-term follow-up 
      periods, further studies are needed to elucidate exact reasons for this 
      phenomenon.
FAU - Yin, Fa-Hui
AU  - Yin FH
AUID- ORCID: 0000-0002-1948-6667
AD  - The First Medical Clinical College of Lanzhou University, Lanzhou, Gansu, China.
FAU - Fan, Chun-Lei
AU  - Fan CL
AD  - The First Medical Clinical College of Lanzhou University, Lanzhou, Gansu, China.
FAU - Guo, Ya-Ya
AU  - Guo YY
AD  - The First Medical Clinical College of Lanzhou University, Lanzhou, Gansu, China.
FAU - Zhu, Hai
AU  - Zhu H
AD  - Department of Cardiology, Gansu Province People's Hospital, Lanzhou, Gansu, 
      China.
FAU - Wang, Zhi-Lu
AU  - Wang ZL
AUID- ORCID: 0000-0002-0451-5568
AD  - Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, 
      Gansu, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20170428
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - *Cardiac Resynchronization Therapy
MH  - *Electrocardiography
MH  - Heart Failure/*physiopathology/*therapy
MH  - Humans
MH  - Quality of Life
MH  - *Sex Characteristics
MH  - Treatment Outcome
PMC - PMC5409183
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/04/30 06:00
MHDA- 2017/09/08 06:00
PMCR- 2017/04/28
CRDT- 2017/04/29 06:00
PHST- 2017/02/12 00:00 [received]
PHST- 2017/04/07 00:00 [accepted]
PHST- 2017/04/29 06:00 [entrez]
PHST- 2017/04/30 06:00 [pubmed]
PHST- 2017/09/08 06:00 [medline]
PHST- 2017/04/28 00:00 [pmc-release]
AID - PONE-D-17-05674 [pii]
AID - 10.1371/journal.pone.0176248 [doi]
PST - epublish
SO  - PLoS One. 2017 Apr 28;12(4):e0176248. doi: 10.1371/journal.pone.0176248. 
      eCollection 2017.