Key result
Cardiac resynchronization therapy in CTRCD patients increased LVEF by 9.95% and reduced LV end-systolic volume by 39.17 mL over 9 months.
Why the study?
While CRT is established for heart failure with reduced ejection fraction and conduction disorders, its role and benefit in patients with cancer therapy-related cardiac dysfunction (CTRCD) remained unclear.
Does cardiac resynchronization therapy (CRT) improve left ventricular ejection fraction and left ventricular volumes in patients with cancer therapy-related cardiac dysfunction (CTRCD)?
Meta-Analysis (n=110)
Does cardiac resynchronization therapy (CRT) improve left ventricular ejection fraction and left ventricular volumes in patients with cancer therapy-related cardiac dysfunction (CTRCD)?
Answers are grounded in this paper and cite their sources.
CRT significantly improves LVEF and reduces left ventricular end-systolic volume in patients with cancer therapy-related cardiac dysfunction, achieving reverse remodeling comparable to other non-ischemic cardiomyopathies.
Introduction Advances in cancer treatment have increased the number of survivors, making cancer therapy–related cardiac dysfunction (CTRCD) an important concern. While cardiac resynchronization therapy (CRT) is established for heart failure with reduced ejection fraction and conduction disorders, its role in CTRCD remains unclear. We conducted a meta-analysis to assess the benefit of CRT in patients with CTRCD. Methods We performed a literature search of studies showing CRT outcomes in the specific group of CTRCD patients. The outcomes of interest were left ventricular ejection fraction (LVEF) and LV volume improvement. A random effects meta-analysis was done to estimate 95% confidence intervals (CI). Results This analysis included four studies (one prospective and three retrospective) comprising 110 patients with CTRCD, the majority (91%, n = 100) being survivors of breast cancer or lymphoma/leukemia. Baseline LVEF ranged from 18.6% ± 7.6% to 28.5% ± 3.8% (mean 24% ± 7%). After a mean follow-up of 9 ± 5 months, LVEF increased by 9.95% (95% CI 7.79–12.11) and end-systolic volume decreased by 39.17 mL (95% CI 24.99–53.35). Three studies included a control group of patients with other forms of non-ischemic cardiomyopathy who underwent CRT implantation, showing no significant difference in LVEF improvement between the two groups. Conclusion This meta-analysis suggests that CRT improves LVEF and LV volumes in selected patients with CTRCD, with a magnitude of reverse remodeling that appears similar to that observed in other etiologies of non-ischemic cardiomyopathy. However, the evidence is limited to small observational studies, so conclusions about clinical outcomes remain uncertain. Thus, CRT may be considered in cancer patients who meet standard criteria for CRT implantation, but the decision should be individualized and guided by multidisciplinary assessment, cancer prognosis, and competing clinical risks.
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Magalhães et al. (2026) conducted a meta-analysis in Cancer therapy-related cardiac dysfunction (CTRCD) (n=110). Cardiac resynchronization therapy (CRT) vs. Patients with other forms of non-ischemic cardiomyopathy undergoing CRT (in 3 of 4 studies) or baseline pre-CRT values was evaluated on Left ventricular ejection fraction (LVEF) and LV end-systolic volume improvement (MD 9.95%, 95% CI 7.79-12.11). Cardiac resynchronization therapy in CTRCD patients increased LVEF by 9.95% and reduced LV end-systolic volume by 39.17 mL over 9 months.
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