Reduced left ventricular mechanical dispersion at 6 months follow-up after cardiac resynchronization therapy is associated with superior long-term outcome

Bijl, Pieter van der; Khidir, Mand J.H.; Leung, Melissa; Yılmaz, Dilek; Mertens, Bart; Marsan, Nina Ajmone; Delgado, Victoria; Bax, Jeroen J.

doi:10.1016/j.hrthm.2018.05.005

Cited by 12 publications

(31 citation statements)

References 32 publications

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“…The standard deviation of these 17 segments, so-called mechanical dispersion, represents the heterogeneity of electrical conduction in the myocardium (figure 4c). Increased LV mechanical dispersion has been associated with increased risk of SCD and/or ventricular arrhythmias in patients after STEMI, heart failure patients receiving cardiac resynchronisation therapy but also in hypertrophic cardiomyopathy patients where mechanical dispersion was also associated with myocardial fibrosis [72,74,77]. The Rotterdam study, a population-based cohort study among 14 926 participants, demonstrated a >30% increased risk of SCD in patients with COPD, especially in those with frequent exacerbations [78].…”

Section: Size and Functionmentioning

confidence: 99%

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COPD and acute myocardial infarction

2020

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COPD is strongly associated with cardiovascular disease, in particular acute myocardial infarction (AMI). Besides shared risk factors, COPD-related factors, such as systemic inflammation and hypoxia, underlie the pathophysiological interaction between COPD and AMI. The prevalence of COPD amongst AMI populations ranges from 7% to 30%, which is possibly even an underestimation due to underdiagnoses of COPD in general. Following the acute event, patients with COPD have an increased risk of mortality, heart failure and arrhythmias during follow-up. Adequate risk stratification can be performed using various imaging techniques, evaluating cardiac size and function after AMI. Conventional imaging techniques such as echocardiography and cardiac magnetic resonance imaging have already indicated impaired cardiac function in patients with COPD without known cardiovascular disease. Advanced imaging techniques such as speckle-tracking echocardiography and T1 mapping could provide more insight into cardiac structure and function after AMI and have proven to be of prognostic value. Future research is required to better understand the impact of AMI on patients with COPD in order to provide effective secondary prevention. The present article summarises the current knowledge on the pathophysiologic factors involved in the interaction between COPD and AMI, the prevalence and outcomes of AMI in patients with COPD and the role of imaging in the acute phase and risk stratification after AMI in patients with COPD.

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Section: Size and Functionmentioning

confidence: 99%

“…Novel imaging techniques could further help to identify patients at risk for adverse events during follow-up. Insert images taken from figure 4 and reproduced with permission as previously stated [70][71][72][73] with permission from the publisher.…”

Section: Figurementioning

confidence: 99%

COPD and acute myocardial infarction

2020

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“…Of these 11 studies, 9 studies met the predefined inclusion criteria for the systematic review, including 3,981 patients with symptomatic heart failure, undergoing CRT implantation, with complete results for GLS and the primary inclusion endpoint (see Fig. 1 ) [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] . The remaining 2 studies were excluded due to no clear data on the prespecified primary combined outcome.…”

Section: Resultsmentioning

confidence: 99%

“…There was variation between the design of included studies, with 2 being randomised controlled trials [15] , [18] , 3 prospective cohort studies [14] , [16] , [19] and 4 retrospective cohort studies [13] , [17] , [20] , [21] of which 2 studies shared similar patient populations from the same site [13] , [21] . Table 1 provides a complete description of the included study designs.…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 provides a complete description of the included study designs. The size of the patient populations varied significantly between 57 and 1185 individuals [17] , [21] with an overall analysed population of 3,981 patients. The follow-up duration was reported as a mean in 4 studies varying between 19.4 and 28.8 months [14] , [15] , [18] , [20] and as median values in 5 studies varying between 32 and 66 (IQR 25–88.8) months [13] , [16] , [17] , [19] , [21] .…”

Section: Resultsmentioning

confidence: 99%

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Global longitudinal strain as a prognostic marker in cardiac resynchronisation therapy: A systematic review

Appadurai

D’Elia

Mew

et al. 2021

IJC Heart & Vasculature

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Highlights Left ventricular global longitudinal strain (LV GLS) is a sensitive parameter that correlates with myocardial scar burden and fibrosis with potential value in CRT candidates. First systematic review evaluating the existing evidence for the prognostic value of LV GLS in patients undergoing CRT implantation. Despite significantly abnormal baseline GLS at CRT implantation, there is still a significant association between incrementally worse LV GLS at CRT implantation and prognostic outcomes on long-term follow-up.

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Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

Mullens

Auricchio

Martens

et al. 2020

European J of Heart Fail

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113

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Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and all‐cause mortality. Nevertheless, up to two‐thirds of eligible patients are not referred for CRT. Furthermore, post‐implantation follow‐up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three European Society of Cardiology Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and European Association of Cardiovascular Imaging (EACVI), focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post‐procedural care by focusing on four actionable domains: (i) overcoming CRT under‐utilization, (ii) better understanding of pre‐implant characteristics, (iii) abandoning the term ‘non‐response’ and replacing this by the concept of disease modification, and (iv) implementing a dedicated post‐implant CRT care pathway.

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Reduced left ventricular mechanical dispersion at 6 months follow-up after cardiac resynchronization therapy is associated with superior long-term outcome

Abstract: Larger LVMD at 6 months after CRT is independently associated with all-cause mortality and VA. LVMD may be valuable in identifying patients who remain at high mortality risk after CRT implantation.

Cited by 12 publications

References 32 publications

COPD and acute myocardial infarction

COPD and acute myocardial infarction

Global longitudinal strain as a prognostic marker in cardiac resynchronisation therapy: A systematic review

Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

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