Cardiac magnetic resonance in cardiac resynchronization therapy - How useful it can be

  • Marija Zdravkovic Kliničko-bolnicki centar Bezanijska kosa
  • Viseslav Popadic Kliničko-bolnički centar Bežanijska kosa
  • Slobodan Klasnja
Keywords: cardiac magnetic resonance, cardiac resynchronization therapy, heart failure, mechanical dyssynchrony, myocardial scar burden

Abstract


Patients with heart failure, reduced ejection fraction, and signs of myocardial dyssynchrony have a poor prognosis. Cardiac resynchronization therapy is a proven therapeutic modality that improves symptoms of heart failure and reduces morbidity and mortality in these patients. Better identification of patients who could respond to cardiac resynchronization therapy is an important aspect. Cardiac magnetic resonance is a useful, non-invasive, sophisticated diagnostic tool that can provide useful information on the etiology of heart failure, and the severity of mechanical dyssynchrony of the left ventricle. It is helpful in evaluating the myocardial scar burden and in the optimal positioning of the LV lead to improve clinical outcomes. Significant clinical benefit has also been proven in following the patients after CRT implantation.

References

[1] Charron P, Elliott PM, Gimeno JR, Caforio ALP, Kaski JP, Tavazzi L, Tendera M, Maupain C, Laroche C, Rubis P, Jurcut R, Calò L, Heliö TM, Sinagra G, Zdravkovic M, Kavoliuniene A, Felix SB, Grzybowski J, Losi MA, Asselbergs FW, García-Pinilla JM, Salazar-Mendiguchia J, Mizia-Stec K, Maggioni AP. The Cardiomyopathy Registry of the EURObservational Research Programme of the European Society of Cardiology: baseline data and contemporary management. Eur Heart J. 2018;39(20):1784-1793. PMID: 29378019. doi: 10.1093/eurheartj/ehx819.
[2] Gorcsan J. Finding pieces of the puzzle of nonresponse to cardiac resynchronization therapy. Circulation. 2011;123(1):10-2. PMID: 21173347. doi: 10.1161/CIRCULATIONAHA.110.001297.
[3] Popadic V, Zdravkovic M, Hinic S. Correlation between optimal coronary functional assessment results and cardiac magnetic resonance in patients after primary PCI. PCR 2020 Abstract Book.2020.
[4] Klasnja S. Correlation between the usage of anabolic steroids and ST-elevation myocardial infarction in young adults. KBC Bezanijska kosa: Odeljenje kardiologije - Odsek za interventnu kardiologiju i pejsmejker. 2016.
[5] Thomas G, Kim J, Lerman BB. Improving Cardiac Resynchronisation Therapy. Arrhythm Electrophysiol Rev. 2019; 8(3): 220–227. PMID: 31463060. doi: 10.15420/aer.2018.62.3.
[6] Vasiljevic Z, Krljanac G, Zdravkovic M, Lasica R, Trifunovic D, Asanin M. Coronary Microcirculation in Heart Failure with Preserved Systolic Function. Curr Pharm Des. 2018;24(25):2960-2966. PMID: 29992878. doi: 10.2174/1381612824666180711124131.
[7] Chavanon ML, Inkrot S, Zelenak C, Tahirovic E, Stanojevic D, Apostolovic S, Sljivic A, Ristic AD, Matic D, Loncar G, Veskovic J, Zdravkovic M, Lainscak M, Pieske B, Herrmann-Lingen C, Düngen H-D. Regional differences in health-related quality of life in elderly heart failure patients: results from the CIBIS-ELD trial. Clin Res Cardiol. 2017;106(8):645-655. PMID: 28361371. doi: 10.1007/s00392-017-1101-6.
[8] Tee M, Noble JA, Bluemke DA. Imaging techniques for cardiac strain and deformation: comparison of echocardiography, cardiac magnetic resonance and cardiac computed tomography. Expert Rev Cardiovasc Ther. 2013;11(2):221-31. PMID: 23405842. doi: 10.1586/erc.12.182.
[9] Cao JJ, Ngai N, Duncanson L, Cheng J, Gliganic K, Chen Q. A comparison of both DENSE and feature tracking techniques with tagging for the cardiovascular magnetic resonance assessment of myocardial strain. J Cardiovasc Magn Reson. 2018;20(1):26. PMID: 29669563. doi: 10.1186/s12968-018-0448-9.
[10] Obeng-Gyimah E, Nazarian S. Cardiac Magnetic Resonance as a Tool to Assess Dyssynchrony. Card Electrophysiol Clin. 2019;11(1):49-53. PMID: 30717852. doi: 10.1016/j.ccep.2018.11.007.
[11] Thomas G, Kim J, Lerman BB. Improving Cardiac Resynchronisation Therapy. Arrhythm Electrophysiol Rev. 2019; 8(3): 220–227. PMID: 31463060. doi: 10.15420/aer.2018.62.3.
[12] Ypenburg C, Roes SD, Bleeker GB, Kaandrop TAM, de Roos A, Schalij MJ, van der Wall EE, Bax JJ. Effect of total scar burden on contrast-enhanced magnetic resonance imaging on response to cardiac resynchronization therapy. Am J Cardiol. 2007;99(5):657-60. PMID: 17317367. doi: 10.1016/j.amjcard.2006.09.115.
[13] Harb SC, Toro S, Bullen JA, Obuchowski NA, Xu B, Trulock KM, Kwon DH. Scar burden is an independent and incremental predictor of cardiac resynchronisation therapy response. Open Heart. 2019; 6(2): e001067. PMID: 31354957. doi: 10.1136/openhrt-2019-001067.
[14] Ahmed W, Samy W, Tayeh O, Behairy N, El Fattah AA. Left ventricular scar impact on left ventricular synchronization parameters and outcomes of cardiac resynchronization therapy. Int J Cardiol. 2016;222:665-670. PMID: 27517660. doi: 10.1016/j.ijcard.2016.07.158.
[15] Chalil S, Foley PWX, Muyhaldeen SA, et al. Late gadolinium enhancement-cardiovascular magnetic resonance as a predictor of response to cardiac resynchronization therapy in patients with ischaemic cardiomyopathy. Europace. 2007;9(11):1031-7. PMID: 17933857. doi: 10.1093/europace/eum133.
[16] Chalil S, Stegemann B, Muhyaldeen SA, Khadjooi K, Foley PW, Smith REA, Leyva F. Effect of posterolateral left ventricular scar on mortality and morbidity following cardiac resynchronization therapy. Pacing Clin Electrophysiol. 2007;30(10):1201-9. PMID: 17897122. doi: 10.1111/j.1540-8159.2007.00841.x.
[17] Rickard J, Jackson G, Spragg DD, Cronin EM, Baranowski B, Wilson Tang WH, Wilkoff BL, Varma N. QRS prolongation induced by cardiac resynchronization therapy correlates with deterioration in left ventricular function. Heart Rhythm. 2012;9(10):1674-8. PMID: 22583844. doi: 10.1016/j.hrthm.2012.05.013.
[18] Zdravkovic M, Tschope C, Pieske B, Kelle S. Myocardial Fibrosis Due to Exorbitant Exercise or Just Undetected Post-Inflammatory Stages? JACC Cardiovasc Imaging. 2019;12(2):381-382. PMID: 30732724. doi: 10.1016/j.jcmg.2018.12.008.
[19] Bisson A, Pucheux J, Andre C, Bernard A, Pierre B, Babuty D. Localization of Left Ventricular Lead Electrodes in Relation to Myocardial Scar in Patients Undergoing Cardiac Resynchronization Therapy. Heart Rhythm. 2016;13(2):481-9. PMID: 26498258. doi: 10.1016/j.hrthm.2015.10.024.
[20] Taylor RJ, Umar F, Panting JR, Stegemann B, Leyva F. Left ventricular lead position, mechanical activation, and myocardial scar in relation to left ventricular reverse remodeling and clinical outcomes after cardiac resynchronization therapy: a feature-tracking and contrast-enhanced cardiovascular magnetic resonance study. Heart Rhythm. 2016;13(2):481-9. PMID: 26498258. doi: 10.1016/j.hrthm.2015.10.024.
[21 ] Koshy A, Swoboda P, Gierula J, Witte KK. Cardiac magnetic resonance in patients with cardiac resynchronization therapy: is it time to scan with resynchronization on? Europace. 2019;21(4):554-562. PMID: 30608530. doi: 10.1093/europace/euy299.
Published
2020/08/28
Section
Review articles