Journal
CURRENT OPINION IN CARDIOLOGY
Volume 31, Issue 5, Pages 523-530Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HCO.0000000000000314
Keywords
cardiac resynchronization therapy; feature tracking magnetic resonance; heart failure; mechanical dyssynchrony; speckle tracking echocardiography
Categories
Funding
- Medtronic
- Boston Scientific
- Biotronik
- Edwards Lifesciences
- Abbott Vascular
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Purpose of reviewThis article summarizes the most recent imaging techniques to assess left ventricular mechanical dyssynchrony and discusses their value to predict response to cardiac resynchronization therapy (CRT) together with assessment of myocardial scar and cardiac venous anatomy.Recent findingsLeft ventricular mechanical dyssynchrony has been associated with prognosis of heart failure patients and has been shown to influence the efficacy of CRT. Although current guidelines do not recommend the assessment of left ventricular mechanical dyssynchrony to select heart failure patients for CRT, technological advances in echocardiography, cardiac magnetic resonance, nuclear imaging and computed tomography have provided powerful tools to characterize left ventricular mechanical dyssynchrony and predict response to CRT. Most important, these imaging techniques permit integration of additional information that is relevant for the efficacy of CRT, such as the extent and location of myocardial scar and the anatomy of the coronary sinus and tributaries where the left ventricular pacing lead may be positioned.SummaryLeft ventricular mechanical dyssynchrony is an important parameter to select heart failure patients who are candidates for CRT. The integration of this parameter together with extent and location of myocardial scar and cardiac venous anatomy is a key to optimize the efficacy of CRT.
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