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The role of cardiac magnetic resonance in identifying appropriate candidates for cardiac resynchronization therapy — a systematic review of the literature

Bazoukis, George, Hui, Jeremy Man Ho, Lee, Yan Hiu Athena, Chou, Oscar Hou In, Sfairopoulos, Dimitrios, Vlachos, Konstantinos, Saplaouras, Athanasios, Letsas, Konstantinos P., Efremidis, Michael, Tse, Gary, and others. (2022) The role of cardiac magnetic resonance in identifying appropriate candidates for cardiac resynchronization therapy — a systematic review of the literature. Heart Failure Reviews, 27 (6). pp. 2095-2118. ISSN 1382-4147. E-ISSN 1573-7322. (doi:10.1007/s10741-022-10263-5) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:98446)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL:
https://doi.org/10.1007/s10741-022-10263-5

Abstract

Despite the strict indications for cardiac resynchronization therapy (CRT) implantation, a signifcant proportion of patients will fail to adequately respond to the treatment. This systematic review aims to present the existing evidence about the role of cardiac magnetic resonance (CMR) in identifying patients who are likely to respond better to the CRT. A systematic search in the MedLine database and Cochrane Library from their inception to August 2021 was performed, without any limitations, by two independent investigators. We considered eligible observational studies or randomized clinical trials (RCTs) that enrolled patients>18 years old with heart failure (HF) of ischaemic or non-ischaemic aetiology and provided data about the association of baseline CMR variables with clinical or echocardiographic response to CRT for at least 3 months. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA Statement). Following our search strategy, 47 studies were fnally included in our review. CMR appears to have an additive role in identifying the subgroup of patients who will respond better to CRT. Specifcally, the presence and the extent of myocardial scar were associated with increased non-response rates, while those with no scar respond better. Furthermore, existing data show that scar location can be associated with CRT response rates. CMR-derived markers of mechanical desynchrony can also be used as predictors of CRT response. CMR data can be used to optimize the position of the left ventricular lead during the CRT implantation procedure. Specifcally, positioning the left ventricular lead in a branch of the coronary sinus that feeds an area with transmural scar was associated with poorer response to CRT. CMR can be used as a non-invasive optimization tool to identify patients who are more likely to achieve better clinical and echocardiographic response following CRT implantation.

Item Type: Article
DOI/Identification number: 10.1007/s10741-022-10263-5
Uncontrolled keywords: Cardiac resynchronization therapy · Cardiac magnetic resonance · Late gadolinium enhancement · Myocardial fibrosis · CRT response
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: University of Kent (https://ror.org/00xkeyj56)
Depositing User: Gary Tse
Date Deposited: 28 Nov 2022 12:03 UTC
Last Modified: 01 Dec 2022 16:24 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/98446 (The current URI for this page, for reference purposes)

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