Image-guided left ventricular lead placement in cardiac resynchronization therapy for patients with heart failure: a meta-analysis.
Image-guided left ventricular lead placement in cardiac resynchronization therapy for patients with heart failure: a meta-analysis.
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DOI：
10.1186/s12872-015-0034-0
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发表时间：
2015-05-10
影响因子：
2.1
通讯作者：
He B
中科院分区：
文献类型：
--
作者：
Jin Y;Zhang Q;Mao JL;He B
心力衰竭（HF）是一种使人衰弱的疾病，影响着全世界数百万人。治疗心衰的方法之一是心脏再同步化治疗（CRT）。最近，一些研究探讨了超声心动图（ECHO）在优化左心室（LV）导联放置以提高对CRT的反应中的应用。本研究的目的是综合图像引导和标准CRT比较疗效的现有数据。我们检索了PubMed、Cochrane、Embase和ISI Web of Knowledge数据库，检索词组合如下：左心室导联放置、心脏再同步化治疗、图像引导和超声心动图引导。符合所有纳入标准而没有排除标准的研究符合纳入标准。主要观察指标为CRT反应率、左室射血分数变化（LVEF）和左室收缩量变化（LVESV）。次要结局包括全因死亡率和hf相关住院率。我们检索了103篇文章，其中3篇被纳入分析。总共有270名患者被随机分配到图像引导的CRT组，241名患者被随机分配到标准CRT组。综合估计显示图像引导CRT的显着益处（CRT反应：OR， 2.098, 95% CI, 1.432-3.072； LVEF：均值差异，3.457,95% CI, 1.910-5.005； LVESV：均值差异，- 20.36,95% CI, - 27.819 - - 12.902）。影像引导CRT的临床效果明显优于标准CRT。需要进一步的试验来验证影像学在CRT前瞻性优化中的应用。
Heart failure (HF) is a debilitating condition that affects millions of people worldwide. One means of treating HF is cardiac resynchronization therapy (CRT). Recently, several studies have examined the use of echocardiography (ECHO) in the optimization of left ventricular (LV) lead placement to increase the response to CRT. The objective of this study was to synthesize the available data on the comparative efficacy of image-guided and standard CRT. We searched the PubMed, Cochrane, Embase, and ISI Web of Knowledge databases through April 2014 with the following combinations of search terms: left ventricular lead placement, cardiac resynchronization therapy, image-guided, and echocardiography-guided. Studies meeting all of the inclusion criteria and none of the exclusion criteria were eligible for inclusion. The primary outcome measures were CRT response rate, change in LV ejection fraction (LVEF), and change in LV end systolic volume (LVESV). Secondary outcomes included the rates of all-cause mortality and HF-related hospitalization. Our search identified 103 articles, 3 of which were included in the analysis. In total, 270 patients were randomized to the image-guided CRT and 241, to the standard CRT. The pooled estimates showed a significant benefit for image-guided CRT (CRT response: OR, 2.098, 95 % CI, 1.432–3.072; LVEF: difference in means, 3.457, 95 % CI, 1.910–5.005; LVESV: difference in means, −20.36, 95 % CI, −27.819 – −12.902). Image-guided CRT produced significantly better clinical outcomes than the standard CRT. Additional trials are warranted to validate the use of imaging in the prospective optimization of CRT.
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影响因子：
44.5
作者：
Chan, Juliana C. N.;Zhang, Yuying;Ning, Guang
通讯作者：
Ning, Guang
影响因子：
13
作者：
Kydd, Anna C.;Khan, Fakhar Z.;Dutka, David P.
通讯作者：
Dutka, David P.
影响因子：
24
作者：
Khan, Fakhar Z.;Virdee, Mumohan S.;Dutka, David P.
通讯作者：
Dutka, David P.
影响因子：
39.3
作者：
Cleland JG;Abraham WT;Linde C;Gold MR;Young JB;Claude Daubert J;Sherfesee L;Wells GA;Tang AS
通讯作者：
Tang AS
影响因子：
37.8
作者：
Butter, C;Auricchio, A;Spinelli, J
通讯作者：
Spinelli, J