Cardiac resynchronization therapy guided by multimodality cardiac imaging.

Aims Up to 30-45% of implanted patients are non-responders to CRT.We evaluated the role of a 'CRT team' using cardiac magnetic resonance (CMR) and longitudinal myocardial strain to identify the target area defined as the most delayed and viable region for LV pacing. Methods and results A total of 10...

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Publicado en:European Journal of Heart Failure. Supplements Vol. 18; no. 11; pp. 1375 - 1383
Autores principales: Bertini, Matteo, Mele, Donato, Malagù, Michele, Fiorencis, Andrea, Toselli, Tiziano, Casadei, Francesca, Cannizzaro, Teresa, Fragale, Cristina, Fucili, Alessandro, Campagnolo, Elena, Benea, Giorgio, Ferrari, Roberto
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2016
      vid: 18
      iid: 11
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        122325946
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        10.1002/ejhf.605
        122325946
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        atl: Cardiac resynchronization therapy guided by multimodality cardiac imaging.
      aug:
        au:
          Bertini, Matteo
          Mele, Donato
          Malagù, Michele
          Fiorencis, Andrea
          Toselli, Tiziano
          Casadei, Francesca
          Cannizzaro, Teresa
          Fragale, Cristina
          Fucili, Alessandro
          Campagnolo, Elena
          Benea, Giorgio
          Ferrari, Roberto
        affil: Department of Cardiology, University of Ferrara, S. Anna Hospital, Cona-Ferrara, Italy
      sug:
        subj:
          Cardiac Resynchronization Therapy
          Heart Failure
          Magnetic Resonance Spectroscopy
          Appointments and Schedules
          Computer Terminals
      ab: Aims Up to 30-45% of implanted patients are non-responders to CRT.We evaluated the role of a 'CRT team' using cardiac magnetic resonance (CMR) and longitudinal myocardial strain to identify the target area defined as the most delayed and viable region for LV pacing. Methods and results A total of 100 heart failure patients candidates for CRT divided into two groups were enrolled. Group 1 consisted of 50 consecutive patients scheduled for CRT and prospectively included. Group 2 (control) consisted of 50 patients with a CRT device implanted according to standard clinical practice and matched for age, sex, and LVEF with group 1. Patients were evaluated at baseline and at 6-month follow-up. In group 1, patients underwent two-dimensional speckle-tracking assessment of longitudinal myocardial strain and CMR imaging to identify the target area for LV lead pacing. A positive response to CRT was defined as a reduction of ≥15% of the LV end-systolic volume at 6-month follow-up. A total of 39 (78%) patients of group 1 were classified as responders to CRT whilst in group 2, only 28 (56%) were responders (P = 0.019). The 'CRT team' identified as target for LV pacing the lateral area in 30 (60%) patients, and the anterolateral or posterolateral areas in 12 (24%) patients. In 8 (16%) patients, the target was far from the lateral area, in the anterior or posterior areas. The patients with concordant position exhibited the highest positive response (93.1%) to CRT. Conclusions Multimodality cardiac imaging as a guide for CRT implantation is useful to increase response rate.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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