Area of Left Ventricular Regional Conduction Delay and Preserved Myocardium Predict Responses to Cardiac Resynchronization Therapy

Tse, Hung‐Fat; Lee, Kathy Lf; Sh, Wan; Yu, Yinghong; Hoersch, Walter; Pastore, Joseph; Zhu, Qing–Ling; KenKnight, Bruce H.; Spinelli, Julio; Lau, Chu‐Pak

doi:10.1046/j.1540-8167.2005.40568.x

Cited by 27 publications

(19 citation statements)

References 24 publications

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“…A study using electromechanical endocardial mapping to assess regional viability in patients with dilated cardiomyopathy showed that pacing from sites with reduced local viability yielded less improvement in maximal LV dp/dt, a measure of LV performance (34).…”

Section: Discussionmentioning

confidence: 99%

Delayed Enhancement Magnetic Resonance Imaging Predicts Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Dyssynchrony

White

Yee

Yuan

et al. 2006

Journal of the American College of Cardiology

340

201

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Section: Discussionmentioning

confidence: 99%

Delayed Enhancement Magnetic Resonance Imaging Predicts Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Dyssynchrony

White

Yee

Yuan

et al. 2006

Journal of the American College of Cardiology

340

201

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“…Left ventricular pacing from anatomically different sites has been shown to yield varying changes in systolic performance (28). A study using electromechanical endocardial mapping to assess regional viability in patients with DCM showed that pacing from sites with reduced local viability yielded less improvement in maximal LV dp/dt, a measure of LV performance (29). In elegant study using LGE-CMR, Bleeker et al (30) have recently shown that in patients with a transmural posterolateral LV scar, CRT did not lead to reductions in left ventricular dyssynchrony or LV size, nor to an improvement in LV ejection fraction.…”

Section: Interventricular Dysynchronymentioning

confidence: 99%

Selection of candidates for cardiac resynchronization therapy: late gadolinium enhanced cardiac magnetic resonance as a new and promising predictor of intraventricular dyssynchrony

Gürel¹,

Tigen²

2011

Anadolu Kardiyol Derg

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ÖZETKardiyak resenkronizasyon tedavisi (KRT) ventrikül içi ileti gecikmesi olan hastalar için önemli bir tedavi seçeneği olup, seçilmiş kalp yetmezliği hastalarında mortalite ve morbiditeyi azalttığı gösterilmiştir. Ventrikül içi gecikmeyi tanımlamak ve KRT adaylarını seçmek için, renkli doku Doppler ekokardiyografi ve benek takibi gibi, çeşitli ekokardiyografik yöntemler önerilmiştir. Bu dikkatlice seçilmiş hastaların yaklaşık %30'u yanıt vermediğine göre, KRT'ne yanıtın öngörücüleri hala araştırma konusu olarak kalmaya devam etmektedir. Son zamanlarda kardiyak manyetik rezonans (KMR) görüntülemelerdeki geç gadolinyum tutulumu tarafından gösterilen miyokardiyal fibrozis, hem intraventriküler dissenkroninin hem de KRT'ne cevabın gelecek vadeden öngörücüsü olarak gösterilmiştir. Bu derlemenin konusu, KRT adaylarını seçmede kullanılan majör ekokardiyografik yön-temler, bu konuda KMR tarafından saptanan kardiyak fibrozisin potansiyel rolü ve kardiyak fibrozisin intraventriküler dissenkroni varlığıyla muhtemel ilişkisidir. ( ABSTRACTCardiac resynchronization therapy (CRT) is an important therapeutic option for patients with intraventricular conduction delay and has been shown to reduce mortality and morbidity in selected heart failure patients. Several echocardiographic methods have been proposed to define intraventricular delay and to select candidates for CRT, such as color coded tissue Doppler echocardiography and speckle tracking. Since, up to 30% of these carefully selected patients do not receive benefit; predictors of response to CRT still remain a topic of ongoing investigations. Recently, myocardial fibrosis defined by late gadolinium enhancement on cardiac magnetic resonance (CMR) imaging has been introduced as promising predictor of both intraventricular dyssynchrony and response to CRT. The focus of the present review is the major echocardiographic modalities to select CRT candidates, the potential role of cardiac fibrosis detected by CMR in this respect, and the possible relation of it with the presence of intraventricular dyssynchrony.

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“…Three-dimensional electromechanical endocardial mapping of LV was used by Tse et al to predict successful response in CRT in patients with dilated cardiomyopathy and LBBB [11]. However, this method is invasive and cannot be routinely performed.…”

Section: Discussionmentioning

confidence: 99%

Fragmented QRS and Ventricular Dyssynchrony in a Patient Treated with Cardiac Resynchronization Therapy

Paraskevaidis¹,

Γιαννακούλας²,

Polymeropoulos³

et al. 2009

TOCTSJ

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Cardiac resynchronization is an established treatment modality in patients with heart failure NYHA class III-IV on optimal medical treatment, QRS duration of at least 120-130 ms and ejection fraction <35%. Nevertheless, a proportion of patients, up to 20-30%, are considered non-responders as they are not improved by cardiac resynchronization therapy (CRT). This report describes a 63-year-old patient with ischemic cardiomyopathy, severe mitral regurgitation, and fragmented QRS complex in several leads. The patient had LV dyssynchrony identified by echocardiographic tissue Doppler imaging. A biventricular pacemaker was implanted successfully, and resulted in improvement in LV dyssynchrony, LV dimensions, mitral regurgitation and symptoms. Fragmented QRS complex as a marker of ventricular dyssynchrony may play a role in identifying patients who may benefit from cardiac resynchronization therapy.

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Area of Left Ventricular Regional Conduction Delay and Preserved Myocardium Predict Responses to Cardiac Resynchronization Therapy

Abstract: The presence of a larger amount of LV area with late Endo-AT and preserved LV myocardium measured by electromechanical mapping could identify patients who have better acute improvement in systolic performance during LV stimulation.

Cited by 27 publications

References 24 publications

Delayed Enhancement Magnetic Resonance Imaging Predicts Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Dyssynchrony

Delayed Enhancement Magnetic Resonance Imaging Predicts Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Dyssynchrony

Selection of candidates for cardiac resynchronization therapy: late gadolinium enhanced cardiac magnetic resonance as a new and promising predictor of intraventricular dyssynchrony

Fragmented QRS and Ventricular Dyssynchrony in a Patient Treated with Cardiac Resynchronization Therapy

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