Prediction of response to cardiac resynchronization therapy by cine- and velocity encoded cardiac magnetic resonance imaging
Journal of Cardiovascular Magnetic Resonance volume 12, Article number: P63 (2010)
Quantification of mechanical dyssynchrony can help to identify responders to cardiac resynchronization therapy (CRT).
The purpose of the present study was to evaluate the ability of cine- and velocity encoded (VENC) magnetic resonance imaging (MRI) to predict response to CRT.
The study included twenty patients with heart failure NYHA class III and reduced ejection fraction (24 (18-28) %), scheduled for CRT device implantation. All patients underwent cine- and VENC-MRI before device implantation. Intra-ventricular dyssynchrony was measured by cine-MRI as the septal-to-lateral mechanical delay (SLMD). The inter-ventricular mechanical delay (IVMD) was assessed by VENC-MRI as the difference between onset of aortic and pulmonary flow. Clinical response to CRT was assessed at 6-month follow-up after device implantation.
Fourteen (70%) patients were classified as clinical responders to CRT. The SLMD and IVMD were longer in responders (336 (165-389) ms and 78 (25-105) ms) than in non-responders (49 (-25-335) ms and 9 (0-31) ms) to CRT (P = 0.05 and 0.02, respectively). Cine-MRI yielded an area under the curve of 0.79 (P = 0.05) to predict response to CRT by measurements of SLMD. The area under the curve was 0.83 (P = 0.02) to predict response to CRT by VENC-MRI measurements of IVMD. Figure 1 demonstrates measurements of IVMD by VENC-MRI in a responder (IVMD = 92 ms, figure 1A) and a non-responder (IVMD = 25 ms, figure 1 B) to CRT.
Cine- and VENC-MRI have the ability to identify responders to CRT.
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Muellerleile, K., Baholli, L., Groth, M. et al. Prediction of response to cardiac resynchronization therapy by cine- and velocity encoded cardiac magnetic resonance imaging. J Cardiovasc Magn Reson 12 (Suppl 1), P63 (2010). https://doi.org/10.1186/1532-429X-12-S1-P63