The effectiveness of cardiac resynchronization therapy in patients with chronic heart failure of various origin depending on the structural myocardial injury in cardiac magnetic resonance imaging

Autor: O. V. Stukalova, N. A. Mironova, M. D. Utsumueva, S. Yu. Kashtanova, E. A. Butorova, V. N. Shitov, G. S. Tarasovsky, S. P. Golitsyn, S. K. Ternovoy
Jazyk: ruština
Rok vydání: 2019
Předmět:
Zdroj: Российский кардиологический журнал, Vol 0, Iss 12, Pp 22-32 (2019)
Druh dokumentu: article
ISSN: 1560-4071
2618-7620
DOI: 10.15829/1560-4071-2019-12-22-32
Popis: Aim. To assess the effect of the size and pattern of myocardial structural injury, determined by magnetic resonance imaging (MRI), on response to cardiac resynchronization therapy (CRT) in patients with ischemic and non-ischemic heart failure (HF).Material and methods. Forty seven patients with ischemic and non-ischemic HF (age 62,3±8,9 years (mean±SD), 44,6% females and 55,4% males), left ventricle (LV) ejection fraction 130 ms, and sinus rhythm were included in the study. Late-gadolinium enhancement-cardiovascular magnetic resonance (LGE-CMR) was undertaken to evaluate myocardial scar prior to CRT devices implantation. All CMR analysis was performed on CVI42 software. According to signal intensity, fibrosis zone and “grey zone” were defined for quantitative analysis (proportion and mass) of injury. Scar zone included fibrosis zone and “grey zone”. Scar location was assessed using a 16-segmentLV model. Response was defined as a reduction inLV end systolic volume of >15% at 6 months follow-up and HF functional class amelioration.Results. In nonresponse group there was significantly higher proportion and mass of total scar (median 4% [2,5; 19] vs 24% [7; 44], p=0,012,6 g [3,5; 32,5] vs41 g [8; 86], p=0,013)), fibrosis zone (median 0% [0; 3,5] vs 8% [0; 19], p=0,01,0 g [0; 6] vs14 g [0; 34], p=0,014) and “grey zone” (4% [2,5; 15] vs 15% [7; 23], p=0,018,6 g [3,5; 27,5] vs23 g [8; 39], p=0,25). Response proportion in non-ischemic HF patients was higher than in ischemic HF patients (78,5% vs 28,5%, p
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