Assessment of dyssynchrony by gated myocardial perfusion imaging does not improve patient management
Clinical trials have demonstrated improved outcomes with cardiac resynchronization therapy in patients with heart failure and electrical evidence of dyssynchrony. There has been intense effort at developing imaging markers of dyssynchrony with the aim of improved risk stratification. However, these efforts have not been fruitful to date. This article discusses mechanisms of cardiac dyssynchrony, reviews clinical data supporting resynchronization therapy, and addresses the lack of convincing evidence to support the use of noninvasive imaging measures of dyssynchrony in improving patient management.
KeywordsCardiomyopathy Heart failure Dyssynchrony Cardiac resynchronization therapy Dyssynchrony imaging
Dr. Lee has no relevant disclosures. Dr. Murthy owns stock in General Electric, Cardinal Health and Covidien. He has received speaker’s fees from Bracco Diagnostics and Ionetix. He has received research funding from INVIA Medical Imaging Solutions. Drs. Shah and Murthy are supported by Grant 1R01HL136685 from the National Heart, Lung, and Blood Institute.
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