title: Echocardiographic assessment of ventricular asynchrony in dilated cardiomyopathy and congenital heart disease: tools and hopes.
abstract: Ventricular dyssynchrony is a relatively common problem in patients with heart failure, in particular those with wide QRS complex, and appears to have a deleterious effect on the natural history of heart failure, as it has been associated with increased mortality. Mechanistic studies, observational evaluations, and randomized trials have consistently demonstrated the beneficial effects of cardiac resynchronization therapy (CRT) in patients with moderate-to-severe chronic systolic heart failure and ventricular dyssynchrony who have failed optimal medical treatment. However, despite the promising results, it is estimated that in approximately 30% of patients undergoing CRT, the symptoms of heart failure do not improve or become even worse. One of the most important reasons for this failure is probably the lack of distinct mechanical dyssynchrony before implantation. A number of echocardiographic tools have been developed during the past 3 years for quantitative measurement of the severity of dyssynchrony before and after CRT. This review discusses the actual and potential role of different echocardiographic techniques in selection of patients and optimization of CRT and the value of some new clinical applications such as in congenital heart disease.
authors.affiliation: La Sapienza University, Rome, Italy. vitar@tiscali.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitarelli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Franciosa
authors.forename: Ysabel
authors.initials: Y
authors.lastname: Conde
authors.forename: Ester
authors.initials: E
authors.lastname: Cimino
authors.forename: Bich Lien
authors.initials: BL
authors.lastname: Nguyen
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciccaglione
authors.forename: Miguel Cortes
authors.initials: MC
authors.lastname: Morichetti
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Chachques
authors.forename: Salvatore
authors.initials: S
authors.lastname: Rosanio
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging*; D002986:Clinical Trials as Topic; D005544:Forecasting; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D010818:Practice Patterns, Physicians'; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*