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Left ventricular scar impact on left ventricular synchronization parameters and outcomes of cardiac resynchronization therapy.

Abstract：

BACKGROUND:Left ventricular scar, including global scar and lateral wall, plays an important role in predicting response to cardiac resynchronization therapy (CRT). MATERIALS AND METHODS:Thirty patients underwent CRT implantation. Assessment of left ventricular (LV) dyssynchrony was done through Gated SPECT LV phase analysis. Pre-implantation cardiac magnetic resonance (CMR) with late gadolinium enhancement technique to examine LV scar burden. Echocardiographic examination of LV end-systolic volume (LVES) prior to CRT and 6 months later. RESULTS:Thirty patients received CRT (mean age 58.7±9.0, 24 males). Reverse LV remodeling (decline ≥15% from baseline VES) was documented in 19 patients. Temporal changes in LV dyssynchrony parameters were correlated to LV reverse remodeling. Applying ROC for predicting CRT non-response showed a cutoff 36.5% of global LV scar burden had a sensitivity of 81.8% and specificity of 68.4%. A cutoff for lateral wall scar burden 40.5% of whole lateral wall had a sensitivity of 72.7% and specificity of 68.4%. CONCLUSION:Reverse LV remodeling is associated with temporal improvements in LV dyssynchrony parameters. LV scar had an unfavorable impact on CRT response. Both global and lateral wall scar burden could predict CRT nonresponse status.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Ahmed W,Samy W,Tayeh O,Behairy N,Abd El Fattah A

doi

10.1016/j.ijcard.2016.07.158

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

665-670

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(16)31552-2

journal_volume

222

pub_type

杂志文章

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