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Improved Left Atrial Function in CRT Responders: A Systematic Review and Meta-Analysis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.ORCID iD: 0000-0002-8996-4257
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.ORCID iD: 0000-0003-0410-968x
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Molecular and Clinic Research Institute, St George University, London, UK.ORCID iD: 0000-0002-6089-5614
2020 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, no 2, article id 298Article, review/survey (Refereed) Published
Abstract [en]

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, p < 0.001 and a WMD of -8.98% [CI -15.1 to -2.84, p = 0.004], compared to non-responders. The increase in LA strain was associated with a fall in left ventricle (LV) end-systolic volume (LVESV) r = -0.56 (CI -0.68 to -0.40, p < 0.001) and an increase in the LV ejection fraction (LVEF) r = 0.58 (CI 0.42 to 0.69, p < 0.001). The increase in LA EF correlated with the fall in LVESV r = -0.51 (CI -0.63 to -0.36, p < 0.001) and the increase in the LVEF r = 0.48 (CI 0.33 to 0.61, p = 0.002). The increase in LA strain correlated with the increase in the LA EF, r = 0.57 (CI 0.43 to 0.70, p < 0.001). Thus, the improvement of LA function in CRT responders reflects LA reverse remodeling and is related to its ventricular counterpart.

Place, publisher, year, edition, pages
MDPI, 2020. Vol. 9, no 2, article id 298
Keywords [en]
left atrial strain, cardiac resynchronization therapy, heart failure
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:umu:diva-169361DOI: 10.3390/jcm9020298ISI: 000518823000011PubMedID: 31973068Scopus ID: 2-s2.0-85114283945OAI: oai:DiVA.org:umu-169361DiVA, id: diva2:1422350
Available from: 2020-04-07 Created: 2020-04-07 Last updated: 2025-02-10Bibliographically approved

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Bytyci, IbadeteBajraktari, GaniLindqvist, PerHenein, Michael Y.

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