# CRT bij inotroop-afhankelijk hartfalen: meta-analyse

*geplaatst 2024-10-01 · Hartfalen · ESC heart failure · doi 10.1002/ehf2.14835 · https://hartvaat.nl/2024/10/01/crt-bij-inotroop-afhankelijk-hartfalen-meta-analyse/*

Meta-analyse onderzocht CRT bij inotroop-afhankelijke hartfalenpatiënten. CRT kan de inotroop-afhankelijkheid doorbreken en de overleving verbeteren, maar de data zijn beperkt en van lage kwaliteit.

## English: Cardiac resynchronization therapy in inotrope-dependent heart failure: a meta-analysis.

This meta-analysis examined cardiac resynchronisation therapy in patients with inotrope-dependent heart failure. CRT may break inotrope dependence and improve survival, although the available evidence is limited and of low quality.

## Abstract (original, from the publication)

AIMS: The viability of cardiac resynchronization therapy (CRT) in inotrope-dependent heart failure (HF) has been a matter of debate. METHODS AND RESULTS: We searched Medline, EMBASE, Scopus, and the Cochrane Library until 31 December 2022. Studies were included if (i) HF patients required inotropic support at CRT implantation; (ii) patients were ≥18 years old; and (iii) they provided a clear definition of 'inotrope dependence' or 'inability to wean'. A meta-analysis was performed in R (Version 3.5.1). Nineteen studies comprising 386 inotrope-dependent HF patients who received CRT (mean age 64.4 years, 76.9% male) were included. A large majority survived until discharge at 91.1% [95% confidence interval (CI): 81.2% to 97.6%], 89.3% were weaned off inotropes (95% CI: 77.6% to 97.0%), and mean discharge time post-CRT was 7.8 days (95% CI: 3.9 to 11.7). After 1 year of follow-up, 69.7% survived (95% CI: 58.4% to 79.8%). During follow-up, the mean number of HF hospitalizations was reduced by 1.87 (95% CI: 1.04 to 2.70, P < 0.00001). Post-CRT mean QRS duration was reduced by 29.0 ms (95% CI: -41.3 to 16.7, P < 0.00001), and mean left ventricular ejection fraction increased by 4.8% (95% CI: 3.1% to 6.6%, P < 0.00001). The mean New York Heart Association (NYHA) class post-CRT was 2.7 (95% CI: 2.5 to 3.0), with a pronounced reduction of individuals in NYHA IV (risk ratio = 0.27, 95% CI: 0.18 to 0.41, P < 0.00001). On univariate analysis, there was a higher prevalence of males (85.7% vs. 40%), a history of left bundle branch block (71.4% vs. 30%), and more pronounced left ventricular end-diastolic dilation (274.3 ± 7.2 vs. 225.9 ± 6.1 mL). CONCLUSIONS: CRT appears to be a viable option for inotrope-dependent HF, with some of these patients seeming more likely to respond.

Auteurs: Nader J Al-Shakarchi, Jamie S Y Ho, Jonathan J H Bray, Fabrizio D'Ascenzo, Edward Duffy, Jack Hewett, Divine Adegbie, Faizullah Khan, Niraj S Kumar, Neal Patel, Mahmood Ahmad, Amitava Banerjee, Ikram Haq, Rui Providencia

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Bron: ESC heart failure, https://doi.org/10.1002/ehf2.14835. Bijgewerkt 2026-07-03T18:39:12Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.