Effect of Total Scar Burden on Contrast-Enhanced Magnetic Resonance Imaging on Response to Cardiac Resynchronization Therapy

It was shown that improvement in left ventricular (LV) function and reverse remodeling after cardiac resynchronization therapy (CRT) were greater in patients with nonischemic cardiomyopathy than in those with ischemic cardiomyopathy. The aim of this study is to evaluate the influence of scar burden...

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Bibliographic Details
Published in:The American journal of cardiology 2007-03, Vol.99 (5), p.657-660
Main Authors: Ypenburg, Claudia, MD, Roes, Stijntje D., MD, Bleeker, Gabe B., MD, Kaandorp, Theodorus A.M., MD, de Roos, Albert, MD, PhD, Schalij, Martin J., MD, PhD, van der Wall, Ernst E., MD, PhD, Bax, Jeroen J., MD, PhD
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Contrast Media
Defibrillators, Implantable
Electric Countershock
Female
Follow-Up Studies
Gadolinium DTPA
Heart
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Myocardial Infarction - pathology
Myocardial Infarction - therapy
NMR
Nuclear magnetic resonance
Prospective Studies
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Therapy
Treatment Outcome
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Summary:It was shown that improvement in left ventricular (LV) function and reverse remodeling after cardiac resynchronization therapy (CRT) were greater in patients with nonischemic cardiomyopathy than in those with ischemic cardiomyopathy. The aim of this study is to evaluate the influence of scar burden on response to CRT. We included 34 patients with ischemic cardiomyopathy (New York Heart Association class 3.1 ± 0.4, LV ejection fraction 23 ± 7%). Contrast-enhanced magnetic resonance imaging was used to determine total scar burden, using a 17-segment model with a 5-point hyperenhancement scale (from score 0 = no hyperenhancement, indicating no scar, to score 4 = hyperenhancement >76%, transmural scar). Linear regression analysis showed a significant correlation (r = −0.91, p 1.20 resulted in complete functional nonresponse. In conclusion, total scar burden, assessed using contrast-enhanced magnetic resonance imaging, is an important factor influencing response to CRT and may be included in the selection process for CRT candidates.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2006.09.115