Why the study?
Response to CRT depends on septal viability and correction of abnormal septal motion, leading researchers to investigate whether CMR can identify CRT responders by combining assessment of septal flash and septal scar.
Does combined assessment of septal scar and septal flash using CMR predict CRT response and long-term survival in CRT recipients?
Population
136 CRT recipients
Comparison
CMR assessment of septal scar and septal flash
Design
Prospective, multicenter, observational study
Follow-up
6 months (primary endpoint) and 39 ± 13 months (secondary endpoint)
Key result
Combined assessment of septal scar and septal flash using CMR accurately predicted CRT response (AUC 0.86; 95% CI 0.78-0.94) and was superior to either parameter alone (p<0.01).
Authors
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May support CMR for CRT candidate selection; leaves open whether prospective use improves outcomes over current criteria.
Observational (n=136)
Yes
Does combined assessment of septal scar and septal flash using CMR predict CRT response and long-term survival in CRT recipients?
Effect estimate: AUC 0.86 (95% CI 0.78-0.94)
p-value: p=<0.01
Combined CMR assessment of septal scar and septal flash accurately predicts echocardiographic response and long-term survival in patients receiving cardiac resynchronization therapy, outperforming QRS duration and morphology.
Larsen et al. (2023) conducted an observational in Heart failure requiring cardiac resynchronization therapy (n=136). Combined assessment of septal scar and septal flash using CMR vs. Septal scar or septal flash alone was evaluated on CRT response, defined as ≥15% reduction in LV end-systolic volume with echocardiography after 6 months (AUC 0.86, 95% CI 0.78-0.94, p=<0.01). Combined assessment of septal scar and septal flash using CMR accurately predicted CRT response (AUC 0.86; 95% CI 0.78-0.94) and was superior to either parameter alone (p<0.01).