Cardiac contractility modulation in patients with heart failure with reduced ejection fraction: a meta-analysis of Russian clinical trials

Aim. To perform a meta-analysis of Russian clinical trials and study the associations of cardiac contractility modulation in patients with heart failure with reduced left ventricular ejection fraction (LVEF). Material and methods. In the meta-analysis; the following outcome measures were selected: Minnesota Living With Heart Failure Questionnaire (MLWHFQ); 6-minute walk test (6MWT); improvement in heart failure functional class; echocardiography data: LVEF; LV end-systolic and end-diastolic volumes; as well as survival rates at 12 and 24 months. Results. The results included in the meta-analysis showed a significant improvement in the 6MWT distance (n=216) (mean difference -38;19; 95% confidence interval (CI): -65;46 to -10;91 m; p=0;006); MLWHFQ results (mean difference 7;28; 95% CI: 2;87-11;69; p=0;001); LVEF (mean difference -4;02; 95% CI: from -5;83 to 2;20; p<0;0001) and LV volume parameters (LV end-diastolic volume: mean difference 19;99; 95% CI: 7;56-32;42; p=0;002; LV end-systolic volume: mean difference 22;68; 95% CI: 12;85-32.51; p<0;001) after 24 months in the cardiac contractility modulation group compared to the control group. Survival was assessed after 12 and 24 months of follow-up — the differences were insignificant. Conclusion. The results of the data from 3 Russian clinical non-randomized studies included in the meta-analysis suggest that cardiac contractility modulation is associated with a significant improvement in quality of life; 6MWT distance; and reverse LV myocardial remodeling.