Cardiac synchronization therapy: Dyssynchrony imaging from a heart failure perspective

Current Opinion in Cardiology

Volumn 23, Issue 6, 2008, Pages 634-645

  Cleland, John G F ^a   Cullington, Damien ^a   Khaleva, Olga ^a   Tageldien, Ahmed ^a  

^a UNIVERSITY OF HULL   (United Kingdom)

Author keywords

Cardiac resynchronization therapy; Heart failure; Implantable defibrillators; Randomized controlled trials

Indexed keywords

CARDIAC DYSSYNCHRONY; CARDIAC RESYNCHRONIZATION THERAPY; CLINICAL ASSESSMENT; CLINICAL TRIAL; DEFIBRILLATOR; DIAGNOSTIC IMAGING; DISEASE SEVERITY; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAM; HEART FAILURE; HEART LEFT VENTRICLE; HEART LEFT VENTRICLE FUNCTION; HEART RHYTHM; HUMAN; HYPOTENSION; MITRAL VALVE REGURGITATION; NOTE; NUCLEAR MAGNETIC RESONANCE IMAGING; PATIENT SELECTION; PRIORITY JOURNAL; PROGNOSIS; QRS COMPLEX; SYMPTOM; SYSTOLIC BLOOD PRESSURE; ECHOGRAPHY; ELECTROCARDIOGRAPHY; HEART PACING; PATHOPHYSIOLOGY; PRACTICE GUIDELINE; RANDOMIZED CONTROLLED TRIAL; REVIEW; TIME;

CARDIAC PACING, ARTIFICIAL; DEFIBRILLATORS, IMPLANTABLE; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAPHY; HEART FAILURE; HUMANS; MITRAL VALVE INSUFFICIENCY; PRACTICE GUIDELINES AS TOPIC; RANDOMIZED CONTROLLED TRIALS AS TOPIC; TIME FACTORS;

EID: 55149083935     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/HCO.0b013e32830c2162     Document Type: Note

References (79)

1. Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 2005; 352:1539-1549.
2. Freemantle N, Tharmanathan P, Calvert MJ, et al. Cardiac resynchronisation for patients with heart failure due to left ventricular systolic dysfunction: a systematic review and meta-analysis. Eur J Heart Fail 2006; 8:433-440.
3. Cleland JG, Daubert JC, Erdmann E, et al. Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase]. Eur Heart J 2006; 27:1928-1932.
4. Cleland JG, Coletta AP, Freemantle N, et al. Clinical trials update from the American College of Cardiology meeting: CARE-HF and the remission of heart failure, Women's Health Study, TNT, COMPASS-HF, VERFTAS, CANPAP, PEECH and PREMIER. Eur J Heart Fail 2005; 7:931-936.
5. Cleland JG, Nasir M, Tageldien A. Cardiac resynchronization therapy or atriobiventricular pacing: what should it be called? Nat Clin Pract Cardiovasc Med 2007; 4:90-101. An important review that started questioning whether there was any evidence that ventricular dyssynchrony was the substrate for cardiac resynchronization therapy. It concluded that there was little evidence for this supposition.
6. Cleland JG. Is aspirin 'the weakest link' in cardiovascular prophylaxis? The surprising lack of evidence supporting the use of aspirin for cardiovascular disease. Prog Cardiovasc Dis 2002; 44:275-292.
7. Cleland J, Freemantle N, Ghio S, et al. Predicting the long-term effects of cardiac resynchronisation therapy on mortality from baseline variables and the early response: a report from CARE-HF (cardiac resynchronisation in heart failure). J Am Coll Cardiol (in press). A complex analysis of data from the CARE-HF study including baseline variables and variables measured 3 months after patients were randomized. The short-term effects of atriobiventricular pacing should reflect the ability of the myocardial or cardiac substrate to respond to the intervention and the adequacy of the pacing in terms of site of pacing and ventricular capture. This analysis showed that very little of the long-term effect of pacing could be explained either by baseline features or by the short-term response.
8. Richardson M, Freemantle N, Calvert MJ, et al. Predictors and treatment response with cardiac resynchronization therapy in patients with heart failure characterized by dyssynchrony: a predefined analysis from the CARE-HF trial. Eur Heart J 2007; 28:1827-1834. An analysis of CARE-HF showed that baseline variables were a poor predictor of the response to CRT. On the contrary, amino-terminal brain natriuretic peptide and the severity of mitral regurgitation were powerful predictors of outcome.
9. Chung ES, Leon AR, Tavazzi L, et al. Results of the Predictors of Response to CRT (PROSPECT) Trial. Circulation 2008; 117:2608-2616. A report on PROSPECT, the largest observational trial conducted so far investigating the relationship between dyssynchrony and the effects of CRT. The study suggested no measure of dyssynchrony was useful in selecting patients and that, even amongst experts, there were large reporting differences.
10. Yao G, Freemantle N, Calvert MJ, et al. The long-term cost-effectiveness of cardiac resynchronization therapy with or without an implantable cardioverterdefibrillator. Eur Heart J 2007; 28:42-51. An analysis of CARE-HF confirmed that atriobiventricular pacing was highly cost-effective and, by imputing an ability of an implantable defibrillator to prevent a proportion of sudden deaths, that CRT-D devices were also cost-effective in younger patients who were less likely to have potentially fatal comorbid conditions.
11. NICE technology appraisal guidance 120. Cardiac resynchronisation therapy for the treatment of heart failure. 2007. www.nice.org.uk/guidance/TA120.
12. Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005; 112:e154-e235.
13. Swedberg K, Cleland J, Dargie H, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005; 26:1115-1140.
14. Cleland JG, Coletta AP, Yassin A, et al. Clinical trials update from the American College of Cardiology 2008: CARISMA, TRENDS, meta-analysis of Cox-2 studies, HAT, ON-TARGET, HYVET, ACCOMPLISH, MOMENTUM, PROTECT, HORIZON-HF and REVERSE. Eur J Heart Fail 2008; 10:614-620.
15. Cleland JG, Freemantle N, Daubert JC, et al. Long-term effect of cardiac resynchronisation in patients reporting mild symptoms of heart failure: a report from the CARE-HF study. Heart 2008; 94:278-283. An analysis of CARE-HF showed that 21 % of patients improved to NYHA class I or II during the run-in phase of the study before receiving CRT. These patients obtained as much benefit on long-term prognosis as did others. These data support those from the recently reported REVERSE study (see [17] for a brief report) that showed a reduction in 1 -year morbidity in patients with predominantly NYHA class II heart failure assigned to CRT.
16. Higgins SL, Hummel JD, Niazi IK, et al. Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias. J Am Coll Cardiol 2003; 42:1454-1459.
17. Abraham WT, Young JB, Leon AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter- defibrillator, and mildly symptomatic chronic heart failure. Circulation 2004; 110:2864-2868.
18. Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004; 350:2140-2150.
19. Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med 2002; 346:1845-1853.
20. Doust JA, Pietrzak E, Dobson A, et al. How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ 2005; 330:625-634.
21. Cleland JC, Goode K. Natriuretic peptides for heart failure. Fashionable? Useful? Necessary? Eur J Heart Fail 2004; 6:253-255.
22. Khan NK, Goode KM, Cleland JG, et al. Prevalence of ECG abnormalities in an international survey of patients with suspected or confirmed heart failure at death or discharge. Eur J Heart Fail 2007; 9:491-501. A detailed account of the ECG abnormalities to be found in a large epidemiologically representative cohort of patients with a discharge diagnosis of heart failure. It showed that QRS duration is inversely related to left ventricular ejection fraction. The reason why QRS duration predicts mortality but echo dyssynchrony does not is that QRS duration is a better measure of the severity of global ventricular dysfunction.
23. Ghio S, Constantin C, Klersy C, et al. Interventricular and intraventricular dyssynchrony are common in heart failure patients, regardless of QRS duration. Eur Heart J 2004; 25:571-578.
24. Aaronson KD, Schwartz JS, Chen TM, et al. Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation 1997; 95:2660-2667.
25. Cowburn PJ, Cleland JG, Coats AJ, et al. Risk stratification in chronic heart failure. Eur Heart J 1998; 19:696-710.
26. Adamson PB, St John Sutton MG, Plappert T. Echo-defined ventricular dyssynchrony predicts magnitude of response to cardiac resynchronisation. J Cardiac Fail 2002; 8:S50.
27. Khaleva O, Nikitin NP, Clark AL. Prognostic role of ventricular dyssynchrony in patients with chronic heart failure. Eur J Heart Fail 2007; 6 (Suppl 1):174. A large cohort study suggesting that neither intraventricular nor interventricular dyssynchrony is associated with an adverse prognosis.
28. Beshai JF, Grimm RA, Nagueh SF, et al. Cardiac-resynchronization therapy in heart failure with narrow QRS complexes. N Engl J Med 2007; 357:2461-2471. The study failed to show an effect of CRT on peak oxygen consumption in a double-blind study lasting 6 months in patients with echocardiographic dyssynchrony and QRS less than 130ms. The study was underpowered and did not look at long-term outcome. However, CRT improved symptoms regardless of QRS duration. This trial is hard to interpret but provides modest encouragement to the argument that QRS is irrelevant when selecting patients for CRT.
29. Achilli A, Peraldo C, Sassara M, et al. Prediction of response to cardiac resynchronization therapy: the selection of candidates for CRT (SCART) study. Pacing Clin Electrophysiol 2006; 29 (Suppl 2):S11-S19.
30. Sleeker QB, Mollema SA, Holman ER, et al. Left ventricular resynchronization is mandatory for response to cardiac resynchronization therapy: analysis in patients with echocardiographic evidence of left ventricular dyssynchrony at baseline. Circulation 2007; 116:1440-1448.
31. Cazeau SJ, Daubert JC, Tavazzi L, et al. Responders to cardiac resynchronization therapy with narrow or intermediate QRS complexes identified by simple echocardiographic indices of dyssynchrony: the DESIRE study. Eur J Heart Fail 2008; 10:273-280.
32. de Sisti A, Toussaint JF, Lavergne T, et al. Determinants of mortality in patients undergoing cardiac resynchronization therapy: baseline clinical, echocardiographic, and angioscintigraphic evaluation prior to resynchronization. Pacing Clin Electrophysiol 2005; 28:1260-1270.
33. Diaz-Infante E, Mont L, Leal J, et al. Predictors of lack of response to resynchronization therapy. Am J Cardiol 2005; 95:1436-1440.
34. Gasparini M, Regoli F, Ceriotti C, et al. Remission of left ventricular systolic dysfunction and of heart failure symptoms after cardiac resynchronization therapy: temporal pattern and clinical predictors. Am Heart J 2008; 155: 507-514.
35. Her MA, Hu T, Ayyagari S, et al. Prognostic value of electrocardiographic measurements before and after cardiac resynchronization device implantation in patients with heart failure due to ischemic or nonischemic cardiomyopathy. Am J Cardiol 2008; 101:359-363.
36. Lecoq G, Leclercq C, Leray E, et al. Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced heart failure. Eur Heart J 2005; 26:1094-1100.
37. Mollema SA, Bleeker GB, van der Wall EE, et al. Usefulness of QRS duration to predict response to cardiac resynchronization therapy in patients with end-stage heart failure. Am J Cardiol 2007; 100:1665-1670.
38. Reuter S, Garrigue S, Barold SS, et al. Comparison of characteristics in responders versus nonresponders with biventricular pacing for drug-resistant congestive heart failure. Am J Cardiol 2002; 89:346-350.
39. Reynolds MR, Joventino LP, Josephson ME. Relationship of baseline electrocardiographic characteristics with the response to cardiac resynchronization therapy for heart failure. Pacing Clin Electrophysiol 2004; 27:1513-1518.
40. Yeim S, Bordachar P, Reuter S, et al. Predictors of a positive response to biventricular pacing in patients with severe heart failure and ventricular conduction delay. Pacing Clin Electrophysiol 2007; 30:970-975.
41. Achilli A, Sassara M, Ficili S, et al. Long-term effectiveness of cardiac resynchronization therapy in patients with refractory heart failure and 'narrow' QRS. J Am Coll Cardiol 2003; 42:2117-2124.
42. Bleeker GB, Holman ER, Steendijk P, et al. Cardiac resynchronization therapy in patients with a narrow QRS complex. J Am Coll Cardiol 2006; 48:2243-2250.
43. Gasparini M, Regoli F, Galimberti P, et al. Three years of cardiac resynchronization therapy: could superior benefits be obtained in patients with heart failure and narrow QRS? Pacing Clin Electrophysiol 2007; 30 (Suppl 1):S34-S39.
44. Yu CM, Chan YS, Zhang Q, et al. Benefits of cardiac resynchronization therapy for heart failure patients with narrow QRS complexes and coexisting systolic asynchrony by echocardiography. J Am Coll Cardiol 2006; 48:2251-2257.
45. Doshi RN, Daoud EG, Fellows C, et al. Left ventricular-based cardiac stimulation post AV nodal ablation evaluation (the PAVE study). J Cardiovasc Electrophysiol 2005; 16:1160-1165.
46. Leclercq C, Walker S, Linde C, et al. Comparative effects of permanent biventricular and right-univentricular pacing in heart failure patients with chronic atrial fibrillation. Eur Heart J 2002; 23:1780-1787.
47. Hoppe UC, Casares JM, Eiskjaer H, et al. Effect of cardiac resynchronization on the incidence of atrial fibrillation in patients with severe heart failure. Circulation 2006; 114:18-25.
48. Boriani G, Muller CP, Seidl KH, et al. Randomized comparison of simultaneous biventricular stimulation versus optimized interventricular delay in cardiac resynchronization therapy. The Resynchronization for the HemodYnamic Treatment for Heart Failure Management II implantable cardioverter defibrillator (RHYTHM II ICD) study. Am Heart J 2006; 151:1050-1058.
49. Rao RK, Kumar UN, et al. Reduced ventricular volumes and improved systolic function with cardiac resynchronization therapy: a randomized trial comparing simultaneous biventricular pacing, sequential biventricular pacing, and left ventricular pacing. Circulation 2007; 115:2136-2144. The study and [48] suggest that attempts to optimize the interventricular interval are of little use. This adds further weight to the argument that ventricular dyssynchrony is not a key component of the response to CRT, otherwise manipulation should have contributed more to benefit.
50. Whinnett ZI, Davies JE,Willson K, et al. Haemodynamic effects of changes in atrioventricular and interventricular delay in cardiac resynchronisation therapy show a consistent pattern: analysis of shape, magnitude and relative importance of atrioventricular and interventricular delay. Heart 2006; 92:1628-1634.
51. Gold MR, Feliciano Z, Gottlieb SS, et al. Dual-chamber pacing with a short atrioventricular delay in congestive heart failure: a randomized study. J Am Coll Cardiol 1995; 26:967-973.
52. Brecker SJ,Xiao HB, Sparrow J, et al. Effects of dual-chamber pacing with short atrioventricular delay in dilated cardiomyopathy. Lancet 1992; 340: 1308-1312.
53. Auricchio A, Klein H, Spinelli J. Pacing for heart failure: selection of patients, techniques and benefits. Eur J Heart Fail 1999; 1:275-279.
54. Cleland JG, Taylor J, Tendera M. Prognosis in heart failure with a normal ejection fraction. N Engl J Med 2007; 357:829-830.
55. McGowan JH, Cleland JG. Reliability of reporting left ventricular systolic function by echocardiography: a systematic review of 3 methods. Am Heart J 2003; 146:388-397.
56. Penicka M, Bartunek J,De Bruyne B, et al. Improvement of left ventricular function after cardiac resynchronization therapy is predicted by tissue Doppler imaging echocardiography. Circulation 2004; 109:978-983.
57. Notabartolo D, Merlino JD, Smith AL, et al. Usefulness of the peak velocity difference by tissue Doppler imaging technique as an effective predictor of response to cardiac resynchronization therapy. Am J Cardiol 2004; 94:817-820.
58. Yu CM, Fung JW, Zhang Q, et al. Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation 2004; 110:66-73.
59. Bax JJ, Sleeker GB, Marwick TH, et al. Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J Am Coll Cardiol 2004; 44:1834-1840.
60. Pitzalis MV, Iacoviello M, Romito R, et al. Ventricular asynchrony predicts a better outcome in patients with chronic heart failure receiving cardiac resynchronization therapy. J Am Coll Cardiol 2005; 45:65-69.
61. Yu CM, Zhang Q, Fung JW, et al. A novel tool to assess systolic asynchrony and identify responders of cardiac resynchronization therapy by tissue synchronization imaging. J Am Coll Cardiol 2005; 45:677-684.
62. Duncan AM, Lim E, Clague J, et al. Comparison of segmental and global markers of dyssynchrony in predicting clinical response to cardiac resynchronization. Eur Heart J 2006; 27:2426-2432.
63. Suffoletto MS, Dohi K, Cannesson M, et al. Novel speckle-tracking radial strain from routine black-and-white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy. Circulation 2006; 113:960-968.
64. Mangiavacchi M, Gasparini M, Faletra F, et al. Clinical predictors of marked improvement in left ventricular performance after cardiac resynchronization therapy in patients with chronic heart failure. Am Heart J 2006; 151:477. e471-477.e476.
65. Van de Veire NR, Yu CM, Ajmone-Marsan N, et al. Triplane tissue Doppler imaging: a novel three-dimensional imaging modality that predicts reverse left ventricular remodelling after cardiac resynchronisation therapy. Heart 2008; 94:e9.
66. Yu CM, Abraham WT, Bax J, et al., on behalf of the PROSPECT Investigators. Predictors of response to cardiac resynchronization therapy (PROSPECT): study design. Am Heart J 2006; 149:600-605.
67. Sassone B, Capecchi A, Boggian G, et al. Value of baseline left lateral wall postsystolic displacement assessed by m-mode to predict reverse remodeling by cardiac resynchronization therapy. Am J Cardiol 2007; 100:470-475.
68. Yu CM, Fung WH, Zhang Q, et al. Predictors of left ventricular remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic or dilated cardiomyopathy. Am J Cardiol 2003; 91:684-688.
69. Mele D, Pasanisi G, Capasso F, et al. Left ventricular myocardial deformation dyssynchrony identifies responders to cardiac resynchronization therapy in patients with heart failure. Eur Heart J 2006; 27:1070-1078.
70. Porciani MC, Lilli A, Macione R, et al. Utility of a new left ventricular asynchrony index as a predictor of reverse remodeling after cardiac resynchronization therapy. Eur Heart J 2006; 27:1818-1823.
71. Marcus GM, Rose E, Voloria EM, et al. Septal to posterior wall motion delay fails to predict reverse remodelling or clinical improvement in patients under-going cardiac resynchronisation therapy. J Am Coll Cardiol 2005; 46:2208-2214.
72. Sleeker GB, Kaandorp TA, Lamb HJ, et al. Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy. Circulation 2006; 113:969-976.
73. Chalil S, Foley PW, Muyhaldeen SA, Patel KC, et al. Late gadolinium enhancement-cardiovascular magnetic resonance as a predictor of response to cardiac resynchronization therapy in patients with ischaemic cardiomyopathy. Europace 2007; 9:1031-1037.
74. Chalil S, Stegemann B, Muhyaldeen SA. Effect of posterolateral left ventricular scar on mortality and morbidity following cardiac resynchronisation therapy. Pacing Clin Electrophysiol 2007; 30:1201-1209.
75. White JA, Yee R, Yuan X, et al. Delayed enhancement magnetic resonance imaging predicts response to cardiac resynchronization therapy in patients with intraventricular dyssynchrony. J Am Coll Cardiol 2006; 48:1953-1960.
76. Ypenburg C, Roes SD, Bleeker GB, et al. Effect of total scar burden on contrast-enhanced magnetic resonance imaging on response to cardiac resynchronization therapy. Am J Cardiol 2007; 99:657-660.
77. Luu M, Stevenson WG, Stevenson LW, et al. Diverse mechanisms of unexpected cardiac arrest in advanced heart failure. Circulation 1989; 80:1675-1680.
78. Faggiano P, d'Aloia A, Gualeni A, et al. Mechanisms and immediate outcome of in-hospital cardiac arrest in patients with advanced heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 2001; 87:655-657, A10-11.
79. Chattopadhyay S, Alamgir MF, Nikitin NP, et al. The effect of pharmacological stress on intraventricular dyssynchrony in left ventricular systolic dysfunction. Eur J Heart Fail 2008; 10:412-420. The study shows that dobutamine stress induces dyssynchrony in most patients with a dilated poorly functioning ventricle who do not have dyssynchrony at rest, regardless of QRS duration.