- Design
- Systematic review and meta-analysis of four observational studies
- Population
- 110 patients with cancer therapy-related cardiac dysfunction, mean LVEF 24%
- Primary outcome
- Change in LVEF and LV volumes after CRT
- Effect
- LVEF +9.95 points (7.79 to 12.11); LVESV −39.2 mL
This meta-analysis pooled four studies of cardiac resynchronisation therapy in patients whose heart failure followed cancer treatment, mostly breast cancer and haematological malignancy.
Ejection fraction and ventricular volumes improved to a degree similar to other non-ischaemic cardiomyopathies.
The data are small and observational. They support applying standard device criteria to cancer survivors, with oncology input on prognosis.
- Most patients had survived breast cancer, lymphoma or leukaemia.
- Ejection fraction rose about 10 points over about nine months.
- The response matched CRT in other non-ischaemic cardiomyopathies.
- Cancer prognosis and competing risks should shape the decision.
Why it matters
Survivors of breast cancer and lymphoma with anthracycline cardiomyopathy may be under-referred for device therapy.
Don't overread it
Four small mostly retrospective studies measured imaging, not survival.
The statistics, in plain English
The intervals are narrow but come from 110 non-randomised patients, so those chosen for CRT may already have been healthier.
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