Evidence map›Paper›PMID 38710670›Full record

SynthesisESC heart failure2024

Cardiac resynchronization therapy in inotrope-dependent heart failure: a meta-analysis.

Nader J Al-Shakarchi, Jamie S Y Ho, Jonathan J H Bray, Fabrizio D'Ascenzo, Edward Duffy, Jack Hewett, Divine Adegbie, Faizullah Khan, Niraj S Kumar, Neal Patel and 4 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nader J Al-ShakarchiMayo Clinic, Rochester, MN, USA.ORCID 0000-0003-1496-8103
Jamie S Y HoRoyal Free Hospital, London, UK.
Jonathan J H BrayOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Fabrizio D'AscenzoUniversity of Turin, Turin, Italy.
Edward DuffyUniversity College London, London, UK.
Jack HewettUniversity College London, London, UK.
Divine AdegbieEast and North Hertfordshire NHS Trust, Stevenage, UK.
Faizullah KhanUniversity College London, London, UK.
Niraj S KumarUniversity College London, London, UK.
Neal PatelUniversity College London, London, UK.
Mahmood AhmadRoyal Free Hospital, London, UK.
Amitava BanerjeeInstitute for Health Informatics, University College London, London, UK.
Ikram HaqMayo Clinic, Rochester, MN, USA.
Rui ProvidenciaInstitute for Health Informatics, University College London, London, UK.

Funding

British Heart Foundation (BHF) (GB) AA/18/6/34223National Institute for Health and Care Research (NIHR) (GB) NIHR129463United Kingdom Research and Innovation (UKRI) and European Research Council - Horizon 2020 UKRI10103153
6 · The paper itself

Abstract

aimsThe viability of cardiac resynchronization therapy (CRT) in inotrope-dependent heart failure (HF) has been a matter of debate. METHODS AND

resultsWe searched Medline, EMBASE, Scopus, and the Cochrane Library until 31 December 2022. Studies were included if (i) HF patients required inotropic support at CRT implantation; (ii) patients were ≥18 years old; and (iii) they provided a clear definition of 'inotrope dependence' or 'inability to wean'. A meta-analysis was performed in R (Version 3.5.1). Nineteen studies comprising 386 inotrope-dependent HF patients who received CRT (mean age 64.4 years, 76.9% male) were included. A large majority survived until discharge at 91.1% [95% confidence interval (CI): 81.2% to 97.6%], 89.3% were weaned off inotropes (95% CI: 77.6% to 97.0%), and mean discharge time post-CRT was 7.8 days (95% CI: 3.9 to 11.7). After 1 year of follow-up, 69.7% survived (95% CI: 58.4% to 79.8%). During follow-up, the mean number of HF hospitalizations was reduced by 1.87 (95% CI: 1.04 to 2.70, P < 0.00001). Post-CRT mean QRS duration was reduced by 29.0 ms (95% CI: -41.3 to 16.7, P < 0.00001), and mean left ventricular ejection fraction increased by 4.8% (95% CI: 3.1% to 6.6%, P < 0.00001). The mean New York Heart Association (NYHA) class post-CRT was 2.7 (95% CI: 2.5 to 3.0), with a pronounced reduction of individuals in NYHA IV (risk ratio = 0.27, 95% CI: 0.18 to 0.41, P < 0.00001). On univariate analysis, there was a higher prevalence of males (85.7% vs. 40%), a history of left bundle branch block (71.4% vs. 30%), and more pronounced left ventricular end-diastolic dilation (274.3 ± 7.2 vs. 225.9 ± 6.1 mL).

conclusionsCRT appears to be a viable option for inotrope-dependent HF, with some of these patients seeming more likely to respond.

Indexed as

Cardiac Resynchronization TherapyCardiotonic AgentsHeart FailureHumansCardiotonic AgentsCardiac resynchronization therapyHeart failureInotropeMeta‐analysis

Identifiers

PMID38710670
PMCPMC11424384

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.