The role of echocardiography in cardiac resynchronization therapy.
Echocardiography is the most important imaging tool for managing heart failure patients. With the advent of cardiac resynchronization therapy (CRT), its role has been broadened by data pertaining to patient selection, optimization of device settings, and outcome assessment. Beyond ejection fraction determination, echocardiographic methods that measure tissue velocity and strain may have the capability to determine degree of mechanical dyssynchrony and possibly predict likelihood of benefit with CRT. After implantation (as the ventricles are fully paced, adjusting the atrioventricular delay ), the timing of the right ventricular and left ventricular lead stimulation (ventricular-ventricular optimization) to achieve maximal cardiac filling or ejection may be clinically important. Atrioventricular and ventricular-ventricular optimization rely on echocardiography to determine optimal values. In long-term follow-up, serial measurement of left ventricular volume has significant correlation with mortality and is a reasonable measure of successful CRT; echocardiography is uniquely suited for this purpose.
Mazur
Wojciech
W
The Heart and Vascular Center, Christ Hospital, 2123 Auburn Avenue, Cincinnati, OH 45219, USA.
Chung
Eugene S
ES
D002304:Cardiac Pacing, Artificial / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*