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Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy

1
Department of Cardiology, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, Policlinico di S.Orsola, 40138 Bologna, Italy
2
Department of Cardiology, Karolinska University Hospital, 17177 Stockholm, Sweden
3
Department of Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
4
Department of Clinical Physiology, Karolinska University Hospital, 17177 Stockholm, Sweden
5
Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Received: 16 November 2020 / Revised: 15 December 2020 / Accepted: 16 December 2020 / Published: 19 December 2020
Cardiovascular imaging techniques, including echocardiography, nuclear cardiology, multi-slice computed tomography, and cardiac magnetic resonance, have wide applications in cardiac resynchronization therapy (CRT). Our aim was to provide an update of cardiovascular imaging applications before, during, and after implantation of a CRT device. Before CRT implantation, cardiovascular imaging techniques may integrate current clinical and electrocardiographic selection criteria in the identification of patients who may most likely benefit from CRT. Assessment of myocardial viability by ultrasound, nuclear cardiology, or cardiac magnetic resonance may guide optimal left ventricular (LV) lead positioning and help to predict LV function improvement by CRT. During implantation, echocardiographic techniques may guide in the identification of the best site of LV pacing. After CRT implantation, cardiovascular imaging plays an important role in the assessment of CRT response, which can be defined according to LV reverse remodeling, function and dyssynchrony indices. Furthermore, imaging techniques may be used for CRT programming optimization during follow-up, especially in patients who turn out to be non-responders. However, in the clinical settings, the use of proposed functional indices for different imaging techniques is still debated, due to their suboptimal feasibility and reproducibility. Moreover, identifying CRT responders before implantation and turning non-responders into responders at follow-up remain challenging issues. View Full-Text
Keywords: cardiac resynchronization therapy; cardiovascular imaging; echocardiography; nuclear cardiology; cardiac magnetic resonance cardiac resynchronization therapy; cardiovascular imaging; echocardiography; nuclear cardiology; cardiac magnetic resonance
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MDPI and ACS Style

Valzania, C.; Gadler, F.; Maret, E.; Eriksson, M.J. Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy. Hearts 2020, 1, 166-180. https://0-doi-org.brum.beds.ac.uk/10.3390/hearts1030017

AMA Style

Valzania C, Gadler F, Maret E, Eriksson MJ. Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy. Hearts. 2020; 1(3):166-180. https://0-doi-org.brum.beds.ac.uk/10.3390/hearts1030017

Chicago/Turabian Style

Valzania, Cinzia; Gadler, Fredrik; Maret, Eva; Eriksson, Maria J. 2020. "Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy" Hearts 1, no. 3: 166-180. https://0-doi-org.brum.beds.ac.uk/10.3390/hearts1030017

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