The saga of dyssynchrony imaging: Are we getting to the point

Elena Galli; Vincent Galand; Virginie Le Rolle; Marion Taconne; Adrien Al Wazzan; Alfredo Hernandez; Christophe Leclercq; Erwan Donal

doi:10.3389/fcvm.2023.1111538

The saga of dyssynchrony imaging: Are we getting to the point

Front Cardiovasc Med. 2023 Mar 31:10:1111538. doi: 10.3389/fcvm.2023.1111538. eCollection 2023.

Authors

Elena Galli¹, Vincent Galand¹, Virginie Le Rolle¹, Marion Taconne¹, Adrien Al Wazzan¹, Alfredo Hernandez¹, Christophe Leclercq¹, Erwan Donal¹

Affiliation

¹ Department of Cardiology and Vascular Disease, Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France.

Abstract

Cardiac resynchronisation therapy (CRT) has an established role in the management of patients with heart failure, reduced left ventricular ejection fraction (LVEF < 35%) and widened QRS (>130 msec). Despite the complex pathophysiology of left ventricular (LV) dyssynchrony and the increasing evidence supporting the identification of specific electromechanical substrates that are associated with a higher probability of CRT response, the assessment of LVEF is the only imaging-derived parameter used for the selection of CRT candidates. This review aims to (1) provide an overview of the evolution of cardiac imaging for the assessment of LV dyssynchrony and its role in the selection of patients undergoing CRT; (2) highlight the main pitfalls and advantages of the application of cardiac imaging for the assessment of LV dyssynchrony; (3) provide some perspectives for clinical application and future research in this field.

Conclusion: the road for a more individualized approach to resynchronization therapy delivery is open and imaging might provide important input beyond the assessment of LVEF.

Keywords: cardiac imaging; cardiac resynchronization therapy; heart failure; left ventricular dyssynchrony; left ventricular remodelling.

Publication types

Review