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REVIEW article

Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1406899
This article is part of the Research Topic Pre-Interventional Cardiac Imaging View all 8 articles

Refining Cardiac Resynchronization Therapy: A Comprehensive Review on the Role of Advanced Multimodality Imaging

Provisionally accepted
Flavia-Mihaela Stoiculescu Flavia-Mihaela Stoiculescu 1,2Diana-Ruxandra Hădăreanu Diana-Ruxandra Hădăreanu 2,3Călin-Dinu Hădăreanu Călin-Dinu Hădăreanu 1,2*Ionuț Donoiu Ionuț Donoiu 2,4Cristina Florescu Cristina Florescu 4,5
  • 1 Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova, Romania
  • 2 Spitalul Clinic Judetean de Urgentã Craiova, Craiova, Romania
  • 3 Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, Romania
  • 4 University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
  • 5 Filantropia Clinical Hospital, Bucharest, Romania

The final, formatted version of the article will be published soon.

    Cardiac resynchronization therapy (CRT) offers significant benefits in symptom alleviation, reduction of rehospitalization rates, and overall survival of patients with heart failure (HF) with reduced ejection fraction (rEF). However, despite its proven efficacy, precisely identifying suitable CRT candidates remains a challenge, with a notable proportion of patients experiencing non-response. Accordingly, many attempts have been made to enhance patient selection, and to identify the best imaging parameters to predict the response and survival after CRT implantation. This review article provides a comprehensive overview on the role of multi-modality cardiac imaging in selecting, optimizing, and predicting CRT response and outcomes in HFrEF patients, beginning with an exploration of dyssynchrony types and their impact on HF progression, and an emphasis on the utility of echocardiography in assessing cardiac dyssynchrony. Subsequently, the role of advanced techniques such as speckle tracking and three-dimensional echocardiography, as well as the visual assessment of apical rocking (ApRock) and septal flash (SF) are highlighted. Finally, cardiac magnetic resonance (CMR) scar data, and novel modalities like four-dimensional flow CMR, together with single-photon emission computed tomography offer additional insights, emerging as valuable predictors of CRT response, and potentially refining the identification of suitable CRT candidates.

    Keywords: Cardiac resynchronization therapy (CRT), Heart Failure, Multi-modality cardiac imaging, Cardiac resynchronization therapy optimization, advanced echocardiography, cardiac magnetic resonance, Cardiac dyssynchrony

    Received: 25 Mar 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Stoiculescu, Hădăreanu, Hădăreanu, Donoiu and Florescu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Călin-Dinu Hădăreanu, Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.