Does myocardial scarring quantified by LGE-CMR predict response to cardiac resynchronization therapy in patients with ischaemic cardiomyopathy?
LGE-CMR quantification of myocardial scar size and transmurality, as well as pacing location relative to scar, can predict clinical response to CRT in patients with ischemic cardiomyopathy.
AIM: To determine whether myocardial scarring, quantified using late gadolinium enhancement-cardiovascular magnetic resonance (LGE-CMR), predicts response to cardiac resynchronization therapy (CRT). METHODS AND RESULTS: A total of 45 patients with ischaemic cardiomyopathy age 67.1 +/- 10.4 years (mean +/- SD) underwent assessment of 6 min walking distance (6MWD) and quality of life (QoL) before and after CRT. Scar size (percentage of left ventricular mass), location, and transmurality were assessed prior to CRT using LGE-CMR. Responders (survived for 1 year with no heart failure hospitalizations, and improvement by >or=1 NYHA classes or >or=25% 6MWD) had a higher left ventricular ejection fraction (P = 0.048), smaller scars (or=51% transmurality (P = 0.002). Scar size correlated negatively with change in 6MWD (r = -0.54, P or=33% scar (82 vs. 35%, P or=51% (89 vs. 46%, P or=51% was associated with a particularly poor response rate (23%), compared with scars with or=33%, a transmurality >or=51%, and pacing over a posterolateral scar are associated with a suboptimal response to CRT.
Chalil et al. (Wed,) studied this question.