Imaging predictors of response to cardiac resynchronization therapy: left ventricular work asymmetry by echocardiography and septal viability by cardiac magnetic resonance

• Published in: European heart journal 2020-10, Vol.41 (39), p.3813-3823
• Main Authors: Aalen, John M, Donal, Erwan, Larsen, Camilla K, Duchenne, Jürgen, Lederlin, Mathieu, Cvijic, Marta, Hubert, Arnaud, Voros, Gabor, Leclercq, Christophe, Bogaert, Jan, Hopp, Einar, Fjeld, Jan Gunnar, Penicka, Martin, Linde, Cecilia, Aalen, Odd O, Kongsgård, Erik, Galli, Elena, Voigt, Jens-Uwe, Smiseth, Otto A
• Format: Article
• Language: English
• Subjects: Bioengineering; Cardiac Resynchronization Therapy; Clinical Research; Echocardiography; Heart Failure - diagnostic imaging; Heart Failure - therapy; Humans; Life Sciences; Magnetic Resonance Spectroscopy; Medicin och hälsovetenskap; Prospective Studies; Treatment Outcome; Ventricular Function, Left
• ISSN: 0195-668X; 1522-9645; 1522-9645
• DOI: 10.1093/eurheartj/ehaa603

Abstract Aims  Left ventricular (LV) failure in left bundle branch block is caused by loss of septal function and compensatory hyperfunction of the LV lateral wall (LW) which stimulates adverse remodelling. This study investigates if septal and LW function measured as myocardial work, alone and combined with assessment of septal viability, identifies responders to cardiac resynchronization therapy (CRT). Methods and results  In a prospective multicentre study of 200 CRT recipients, myocardial work was measured by pressure-strain analysis and viability by cardiac magnetic resonance (CMR) imaging (n = 125). CRT response was defined as ≥15% reduction in LV end-systolic volume after 6 months. Before CRT, septal work was markedly lower than LW work (P