Key result
The severity of mechanical systolic asynchrony assessed by echocardiography is a better predictor of response to cardiac resynchronization therapy than electrocardiogram criteria.
Why the study?
Does echocardiographic evaluation of mechanical systolic asynchrony predict response to cardiac resynchronization therapy in patients with moderate to severe heart failure?
Does echocardiographic evaluation of mechanical systolic asynchrony predict response to cardiac resynchronization therapy in patients with moderate to severe heart failure?
This review highlights the potential of echocardiographic indices of mechanical asynchrony to improve patient selection for CRT, addressing the high rate of non-responders based on ECG criteria alone.
Numerous randomized clinical trials demonstrated the beneficial effects of cardiac resynchronization therapy (CRT) in the treatment of moderate to severe heart failure. Despite careful patient selection, there is still a percentage of non-responders, that is as high as 30-50%. Patients are selected mainly on electrocardiogram criteria. Recent studies have observed that the severity of mechanical systolic asynchrony is a much better predictor of a response after CRT. Echocardiography allows a non-invasive evaluation atrioventricular and inter- and intraventricular synchrony; furthermore, recent advances have provided direct evidence of wall motion resynchronization in patients receiving CRT. Nevertheless, although many authors tried to search for the best echocardiographic index to identify systolic asynchrony, and consequently responders to CRT before the procedure, this issue is still a matter of debate. Our aim was to make an updated review of the more recent studies on this topic.
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Fratini et al. (2007) conducted a review in moderate to severe heart failure. Echocardiographic evaluation of mechanical systolic asynchrony vs. Electrocardiogram criteria was evaluated on Response to cardiac resynchronization therapy. The severity of mechanical systolic asynchrony assessed by echocardiography is a better predictor of response to cardiac resynchronization therapy than electrocardiogram criteria.
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