![]() ![]() In this meta-analysis, we found that CRT responders had a baseline and ΔGLS significantly higher than the non-responders strengthening the central role of GLS as a tool for selecting candidates for CRT. These associations remained significant in a subgroup analysis including only studies with similar CRT response definition. Furthermore, CRT responders had significantly greater improvement of GLS at follow-up compared with non-responders. We found that CRT responders had significantly better resting GLS values compared with non-responders. Twelve studies (1004 patients, mean age 63.8 years old, males 69.4%) provided data on the association of baseline GLS with the response to CRT therapy. A p value of less than 0.05 (two-tailed) was considered statistically significant. ![]() ![]() Data analysis was performed by using the Review Manager software (RevMan), version 5.3, and Stata 13 software. Two independent investigators performed a comprehensive systematic search in MedLine, EMBASE and Cochrane databases through September 2019 without limitations. This meta-analysis was performed in accordance to both the Meta-Analysis of Observational Studies in Epidemiology and Strengthening the Reporting of Observational Studies in Epidemiology guidelines. To evaluate the association between baseline global longitudinal strain (GLS) and ΔGLS (difference of baseline GLS and follow-up) and cardiac resynchronization therapy (CRT) response defined either with clinical or with echocardiographic characteristics. Published by Oxford University Press on behalf of the European Society of Cardiology. CRT response by reverse remodelling was dependent on improvement of both longitudinal and circumferential function. Mechanical dispersion at 6 months was a strong predictor of ventricular arrhythmias. In heart failure patients with CRT, worse longitudinal function before CRT was an important predictor of fatal outcome during 2 years, independently of CRT response. CRT responders (59%) had improvement of both GLS and GCS. Mechanical dispersion at 6 months was an independent predictor of ventricular arrhythmias. Patients with GLS better than -8.3% showed event-free survival benefit (log rank, P < 0.001). GLS before CRT was a predictor of fatal end point independently of CRT response. Speckle-tracking technique was performed to assess longitudinal and circumferential left ventricular function, defined as global longitudinal (GLS) and circumferential strain (GCS), and to assess mechanical dyssynchrony, defined as mechanical dispersion. CRT response was defined as ≥15% reduction in end-systolic volume at 6 months. Two-dimensional echocardiography was performed before and 6 months after CRT implantation. We prospectively included 170 heart failure patients (66 ± 10 years, New York Heart Association class 2.8 ± 0.5, 48% ischaemic cardiomyopathy) and recorded ventricular arrhythmias and fatal end point defined as death, heart transplantation, or left ventricular assist device implantation during 2 years. ![]() We aimed to investigate for echocardiographic predictors of ventricular arrhythmias and fatal outcome and to explore how myocardial function is changed by biventricular pacing in heart failure. However, prediction of the outcome remains difficult. Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure. ![]()
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