Associated factors and percentage of cardiac recovery among patients using LVAD: a meta-analysis of 31 studies

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Abstract Introduction Patients with advanced heart failure use left ventricular assist devices (LVAD) to improve their outcomes and enhance the reverse remodeling of the heart. There has been no previous meta-analysis on the percentage of cardiac recovery after LVAD. This study aims to find the pooled percentage of cardiac recovery after LVAD. Methods A systematic search was done in PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to December 2023. We used the relevant keywords to include studies that reported the percentage of people who achieved cardiac recovery after LVAD. The percentage of participants using LVAD and achieving cardiac recovery was extracted from the studies. RevMan 5.4 was used for meta-analysis. Results Thirty-two studies totaling 39215 patients were included. Different types of LVAD were used among participants. Across studies, different definitions for cardiac recovery were used, and the most used one is device explant following cardiac recovery and achieving left ventricular ejection fraction (LVEF) ≥ 40% after using LVAD. The pooled percentage of people who achieved cardiac recovery was 5.06%, 95% CI [4.17, 5.95], and the result was heterogeneous (I2 = 94%, p < 0.00001). Shorter duration of heart failure, female gender, younger age, presence of Implantable cardioverter-defibrillator (ICD) and low left ventricular end-diastolic diameter (LVEDD) were the most common mentioned factors associated with cardiac recovery. Conclusion Low cardiac recovery was found in patients using LVAD, and several factors were associated with cardiac recovery. Further action could be taken to improve the recovery among this population.

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