The role of contractile reserve by stress test echocardiography for predicting cardiac resynchronization therapy responder: systematic review and meta-analysis
Bibliographic record
Abstract
Introduction: Up to one-third of patients who received resynchronization devices do not experience full benefit of cardiac resynchronization therapy (CRT). Echocardiography plays an important role in heart failure patients treated with CRT. Contractile reserved is a strong prognostic factor to predict positive response to CRT (CRT responder). Objective: We perform a systematic review and meta-analysis of published data to assess the relationship between contractile reserve (CR) and response to CRT. Methods: We conduct a systematic search from major medical databases on all clinical trials published up to June 2020, written in English, full-text availability, and human subject. We used Newcastle-Ottawa Scale to measure the quality of evidence. We employed the Mantel–Haenszel random-effects meta-analysis of using RevMan 5.4. Results: We identified 17 studies involving 1399 patients. The type of stress was either dobutamine (n=15) or exercise (n=2). The presence of CR was associated with a higher chance of CRT responder (OR 7.68, 95%CI 4.27–13.82, p<0.001) using a random-effects model. The ORs slightly differed when studies were analyzed separately based on the stress test type and definition of CR. Contractile reserve, assessed with dobutamine stress echocardiography (DSE), defined as an increase in LVEF (OR 5.10, 95% CI 2.29–11.32, P <0.00001) was numerically lower than defined as increased LV contractility (OR 6.86, 95% CI 3.36–12.88, P <0.00001). The presence of CR assessed with exercise stress test are associated with higher chance of CRT responder (OR 49.11, 95% CI 15.04–160.36, P <0.00001). From our meta-analysis, we found non-ischemic has better respond to CRT compare to patient with ischemic etiology (OR 0.41; 95% CI 0.31-0.55, P <0.01). Conclusion: The presence of CR during stress test echocardiography with either dobutamine or exercise stress test is associated with a higher chance of CRT responder.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.048 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.022 | 0.041 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".