Cargando…
Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy
AIM: To determine the feasibility and potential benefit of a full cardiac magnetic resonance (CMR) work-up for assessing the location of scarred myocardium and the region of latest contraction (LCR) in patients with ischaemic cardiomyopathy (ICM) undergoing cardiac resynchronisation therapy (CRT). M...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bohn Stafleu van Loghum
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977813/ https://www.ncbi.nlm.nih.gov/pubmed/31953775 http://dx.doi.org/10.1007/s12471-019-01360-6 |
_version_ | 1783490591701598208 |
---|---|
author | Gathier, W. A. Salden, O. A. E. van Ginkel, D. J. van Everdingen, W. M. Mohamed Hoesein, F. A. A. Cramer, M. J. M. Doevendans, P. A. Meine, M. Chamuleau, S. A. J. van Slochteren, F. J. |
author_facet | Gathier, W. A. Salden, O. A. E. van Ginkel, D. J. van Everdingen, W. M. Mohamed Hoesein, F. A. A. Cramer, M. J. M. Doevendans, P. A. Meine, M. Chamuleau, S. A. J. van Slochteren, F. J. |
author_sort | Gathier, W. A. |
collection | PubMed |
description | AIM: To determine the feasibility and potential benefit of a full cardiac magnetic resonance (CMR) work-up for assessing the location of scarred myocardium and the region of latest contraction (LCR) in patients with ischaemic cardiomyopathy (ICM) undergoing cardiac resynchronisation therapy (CRT). METHODS: In 30 patients, scar identification and contraction timing analysis was retrospectively performed on CMR images. Fluoroscopic left ventricular (LV) lead positions were scored with respect to scar location, and when placed outside scar, with respect to the LCR. The association between the lead position with respect to scar, the LCR and echocardiographic LV end-systolic volume (LVESV) reduction was subsequently evaluated. RESULTS: The CMR work-up was feasible in all but one patient, in whom image quality was poor. Scar and contraction timing data were succesfully displayed on 36-segment cardiac bullseye plots. Patients with leads placed outside scar had larger LVESV reduction (−21 ± 21%, n = 19) compared to patients with leads within scar (1 ± 25%, n = 11), yet total scar burden was higher in the latter group. There was a trend towards larger LVESV reduction in patients with leads in the scar-free LCR, compared to leads situated in scar-free segments but not in the LCR (−34 ± 14% vs −15 ± 21%, p = 0.06). CONCLUSIONS: The degree of reverse remodelling was larger in patients with leads situated in a scar-free LCR. In patients with leads situated within scar there was a neutral effect on reverse remodelling, which can be caused both by higher scar burden or lead position. These findings demonstrate the feasibility of a CMR work-up and potential benefit in ICM patients undergoing CRT. |
format | Online Article Text |
id | pubmed-6977813 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-69778132020-02-06 Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy Gathier, W. A. Salden, O. A. E. van Ginkel, D. J. van Everdingen, W. M. Mohamed Hoesein, F. A. A. Cramer, M. J. M. Doevendans, P. A. Meine, M. Chamuleau, S. A. J. van Slochteren, F. J. Neth Heart J Original Article AIM: To determine the feasibility and potential benefit of a full cardiac magnetic resonance (CMR) work-up for assessing the location of scarred myocardium and the region of latest contraction (LCR) in patients with ischaemic cardiomyopathy (ICM) undergoing cardiac resynchronisation therapy (CRT). METHODS: In 30 patients, scar identification and contraction timing analysis was retrospectively performed on CMR images. Fluoroscopic left ventricular (LV) lead positions were scored with respect to scar location, and when placed outside scar, with respect to the LCR. The association between the lead position with respect to scar, the LCR and echocardiographic LV end-systolic volume (LVESV) reduction was subsequently evaluated. RESULTS: The CMR work-up was feasible in all but one patient, in whom image quality was poor. Scar and contraction timing data were succesfully displayed on 36-segment cardiac bullseye plots. Patients with leads placed outside scar had larger LVESV reduction (−21 ± 21%, n = 19) compared to patients with leads within scar (1 ± 25%, n = 11), yet total scar burden was higher in the latter group. There was a trend towards larger LVESV reduction in patients with leads in the scar-free LCR, compared to leads situated in scar-free segments but not in the LCR (−34 ± 14% vs −15 ± 21%, p = 0.06). CONCLUSIONS: The degree of reverse remodelling was larger in patients with leads situated in a scar-free LCR. In patients with leads situated within scar there was a neutral effect on reverse remodelling, which can be caused both by higher scar burden or lead position. These findings demonstrate the feasibility of a CMR work-up and potential benefit in ICM patients undergoing CRT. Bohn Stafleu van Loghum 2020-01-17 2020-02 /pmc/articles/PMC6977813/ /pubmed/31953775 http://dx.doi.org/10.1007/s12471-019-01360-6 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Gathier, W. A. Salden, O. A. E. van Ginkel, D. J. van Everdingen, W. M. Mohamed Hoesein, F. A. A. Cramer, M. J. M. Doevendans, P. A. Meine, M. Chamuleau, S. A. J. van Slochteren, F. J. Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
title | Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
title_full | Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
title_fullStr | Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
title_full_unstemmed | Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
title_short | Feasibility and potential benefit of pre-procedural CMR imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
title_sort | feasibility and potential benefit of pre-procedural cmr imaging in patients with ischaemic cardiomyopathy undergoing cardiac resynchronisation therapy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977813/ https://www.ncbi.nlm.nih.gov/pubmed/31953775 http://dx.doi.org/10.1007/s12471-019-01360-6 |
work_keys_str_mv | AT gathierwa feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT saldenoae feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT vanginkeldj feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT vaneverdingenwm feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT mohamedhoeseinfaa feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT cramermjm feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT doevendanspa feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT meinem feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT chamuleausaj feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy AT vanslochterenfj feasibilityandpotentialbenefitofpreproceduralcmrimaginginpatientswithischaemiccardiomyopathyundergoingcardiacresynchronisationtherapy |