Association of Cardiac Resynchronization Therapy With Change in Left Ventricular Ejection Fraction in Patients With Chemotherapy-Induced Cardiomyopathy
Key result
Cardiac resynchronization therapy in patients with chemotherapy-induced cardiomyopathy was associated with a significant improvement in mean LVEF by 10.6% (95% CI 8.0%-13.3%; P<.001) at 6 months.
Why the study?
Chemotherapy-induced cardiomyopathy is increasing and associated with poor outcomes, but the association of CRT with cardiac and clinical improvement was unclear.
Does cardiac resynchronization therapy (CRT) improve LVEF in patients with chemotherapy-induced cardiomyopathy?
Population
30 patients with chemotherapy-induced cardiomyopathy, LVEF ≤35%, NYHA II–IV symptoms, and wide QRS complex
Comparison
CRT implantation according to standard of care
Design
Uncontrolled, prospective multicenter cohort study
Follow-up
6 months
Authors
Discussion
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Member takes
Implication
Supports potential CRT benefit in chemotherapy-induced cardiomyopathy; hypothesis-generating and requires randomized confirmation before practice change.
Study Design
Type
Cohort (n=30)
Multicenter
Yes
Structured PICO
Does cardiac resynchronization therapy (CRT) improve LVEF in patients with chemotherapy-induced cardiomyopathy?
P
Population
30 patients (mean age 64, 87% women) with chemotherapy-induced cardiomyopathy, LVEF ≤35%, NYHA class II-IV symptoms, and wide QRS complex, followed for 6 months.
E
Exposure
Cardiac resynchronization therapy (CRT) implantation according to standard of care
O
Outcome
Change in LVEF from baseline to 6 months after initiating CRTsurrogate
Main Result
Mean Difference: 10.6 (95% CI 8–13.3)
p-value: p=<.001
In patients with chemotherapy-induced cardiomyopathy, CRT implantation was associated with a significant improvement in LVEF and reduction in LV volumes at 6 months.
Limitations
- small sample size
- short follow-up
- absence of a control group
Cite This Study
Singh et al. (2019) conducted a cohort in Chemotherapy-induced cardiomyopathy (n=30). Cardiac resynchronization therapy (CRT) was evaluated on Change in LVEF from baseline to 6 months after initiating CRT (MD 10.6%, 95% CI 8.0-13.3, p=<.001). Cardiac resynchronization therapy in patients with chemotherapy-induced cardiomyopathy was associated with a significant improvement in mean LVEF by 10.6% (95% CI 8.0%-13.3%; P<.001) at 6 months.