The riddle of determining cardiac resynchronization therapy response a physiologic approach to dyssynchrony therapy.
نویسندگان
چکیده
ecently published studies have emphasized the technical ifficulty of assessing mechanical left ventricular (LV) synhrony in patients undergoing cardiac resynchronization herapy (CRT). The failure of a large, multicenter study to dentify benefit from CRT in dyssynchronous, narrow omplex heart failure (1), as well as the failure of synchrony arkers to predict success of CRT (2), has cast a cloud over he utility of assessment of mechanical synchrony.
منابع مشابه
[Three-dimensional imaging in cardiac resynchronization therapy].
Cardiac resynchronization therapy improves clinical symptoms and prognosis of heart failure patients. However, it has been shown that up to 40% of patients do not respond to this therapy. Three main determinants of cardiac resynchronization therapy response have been identified: left ventricular dyssynchrony, left ventricular lead position, and extent and location of myocardial scar tissue. Two...
متن کاملCardiac Resynchronization Therapy
Cardiac Resynchronization Therapy. Cardiac resynchronization therapy (CRT) is a recently developed approach to treat dilated heart failure with discoordinate contraction. Such dyssynchrony typically stems from electrical delay that then translates into mechanical delay between the septal and lateral walls. Over the past decade, many studies have examined the pathophysiology of cardiac dyssynchr...
متن کاملEchocardiography, dyssynchrony, and the response to cardiac resynchronization therapy.
Biventricular pacing or cardiac resynchronization therapy (CRT) has been a considerable advance in the therapy of chronic heart failure. However, it is clear that not all patients benefit either in terms of symptoms or cardiac function, and some may be worsened by CRT. In this review, we consider the arguments, both clinical and economical, in favour of improved selection of patients for CRT ot...
متن کاملComparison of CMR DENSE strain imaging and 2D speckle tracking echocardiography for cardiac resynchronization therapy (CRT) response
Background Considering that nonresponse rates to cardiac resynchronization therapy (CRT) are typically 35-50%, assessment of the cardiac substrate for CRT with cardiac imaging could be very helpful for many patients with heart failure referred for this therapy. We have previously shown that CMR assessment of dyssynchrony using displacement encoding with stimulated echoes (DENSE) is strongly ass...
متن کاملClinical Assessment and Implication of Left Ventricular Mechanical Dyssynchrony in Patients with Heart Failure.
UNLABELLED There have been numerous studies focusing on the assessment of left ventricular mechanical dyssynchrony. These studies are diverse in their purposes, which include more effectively predicting the response to cardiac resynchronization therapy, improving the guidance of the left ventricular lead position, and better prediction of outcome in patients with heart failure. This article rev...
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عنوان ژورنال:
- Journal of the American College of Cardiology
دوره 52 17 شماره
صفحات -
تاریخ انتشار 2008