Cardiac resynchronization therapy improves left ventricular function and induces reverse remodeling in patients with non-ischemic cardiomyopathy, with response dependent on mechanical dyssynchrony and myocardial fibrosis.
Patients with non-ischemic cardiomyopathy exhibit higher response rates to cardiac resynchronization therapy compared to those with ischemic cardiomyopathy, partly due to differences in myocardial substrate.
Cardiac resynchronization therapy (CRT) is an established therapy for heart failure patients who remain symptomatic despite optimal medical therapy, have reduced left ventricular ejection fraction (120 ms), preferably with left bundle branch block morphology. The response to CRT depends on the cardiac substrate: presence of correctable left ventricular mechanical dyssynchrony, presence of myocardial fibrosis (scar) and position of the left ventricular pacing lead. Patients with non-ischemic cardiomyopathy have shown higher response rates to CRT compared with patients with ischemic cardiomyopathy. Differences in myocardial substrate may partly explain this disparity. Multimodality imaging plays an important role to assess the cardiac substrate and the pathophysiological determinants of response to CRT.
Shanks et al. (Mon,) conducted a review in Non-ischemic cardiomyopathy. Cardiac Resynchronization Therapy (CRT) was evaluated. Cardiac resynchronization therapy improves left ventricular function and induces reverse remodeling in patients with non-ischemic cardiomyopathy, with response dependent on mechanical dyssynchrony and myocardial fibrosis.