Document Detail

Echocardiography and non-invasive imaging in cardiac resynchronization therapy.
MedLine Citation:
PMID:  20485238     Owner:  NLM     Status:  MEDLINE    
The beneficial effects of cardiac resynchronization therapy (CRT) on morbidity and mortality in advanced heart failure patients have been extensively demonstrated. However, previous single- and multicenter studies demonstrated that approximately 30-40% of CRT patients do not show significant clinical improvement or LV reverse remodeling despite fulfilling current inclusion criteria. In search of novel indices that may help to improve the selection of responders to CRT, non-invasive multimodality imaging has provided further insight into the mechanisms underlying CRT response. LV dyssynchrony, extent and location of myocardial scar and LV lead position have shown to be independent determinants of CRT response. An integrated evaluation of these three pathophysiological mechanisms may provide a more accurate selection of heart failure patients who will benefit from CRT and may maximize the cost-effectiveness of this therapy. The present review article provides a critical appraisal of the role of multimodality imaging in the selection of heart failure patients who are candidates for CRT with special focus on the assessment of LV mechanical dyssynchrony, LV myocardial scar tissue extent and LV lead position.
V Delgado; E A Q Mooyaart; A Ct Ng; D Auger; M Bertini; R J van Bommel; K H Yiu; S H Ewe; T G Witkowski; N Ajmone Marsan; J D Schuijf; E E van der Wall; M J Schalij; J J Bax
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva cardioangiologica     Volume:  58     ISSN:  0026-4725     ISO Abbreviation:  Minerva Cardioangiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400725     Medline TA:  Minerva Cardioangiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  313-32     Citation Subset:  IM    
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis*,  etiology,  therapy*,  ultrasonography
Cardiac Resynchronization Therapy / methods*
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
Cardiomyopathies / diagnosis
Cicatrix / diagnosis
Heart Failure / complications*

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