Effectiveness of cardiac resynchronization therapy in cancer therapy-related cardiac dysfunction: a systematic review and meta-analysis.
Andreia Magalhães, Inês Araújo, Martin Brabec et al.
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In 30 seconds
This systematic review and random-effects meta-analysis assessed cardiac resynchronization therapy (CRT) outcomes in patients with cancer therapy-related cardiac dysfunction (CTRCD). Four studies—one prospective and three retrospective—included 110 patients, most of whom had survived breast cancer or lymphoma/leukemia. At a mean follow-up of 9 ± 5 months, left ventricular ejection fraction increased by 9.95% (95% CI 7.79-12.11), while end-systolic volume decreased by 39.17 mL (95% CI 24.99-53.35). In studies with non-ischemic cardiomyopathy controls, LVEF improvement did not differ significantly between groups.
Key findings
- Across 110 patients, LVEF increased by 9.95% (95% CI 7.79-12.11) after a mean follow-up of 9 ± 5 months.
- End-systolic volume decreased by 39.17 mL (95% CI 24.99-53.35).
- Three studies found no significant difference in LVEF improvement between CTRCD and other non-ischemic cardiomyopathy groups receiving CRT.
Why it matters
The findings suggest that selected patients with CTRCD may experience reverse cardiac remodeling after CRT, with improvement comparable to that reported in other non-ischemic cardiomyopathy groups. This is relevant when considering device therapy in cancer survivors, but the evidence addresses ventricular measures rather than establishing effects on clinical outcomes.
What to keep in mind
Evidence came from only four small observational studies, three retrospective; conclusions about clinical outcomes remain uncertain.