Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

01-01-2016 | Review Article | Uitgave 1/2016 Open Access

Netherlands Heart Journal 1/2016

Echocardiography and cardiac resynchronisation therapy, friends or foes?

Tijdschrift:
Netherlands Heart Journal > Uitgave 1/2016
Auteurs:
W.M. van Everdingen, J.C. Schipper, J. van ’t Sant, K. Ramdat Misier, M. Meine, M.J. Cramer
Belangrijke opmerkingen
An erratum to this article can be found at http://​dx.​doi.​org/​10.​1007/​s12471-016-0807-9.

Abstract

Echocardiography is used in cardiac resynchronisation therapy (CRT) to assess cardiac function, and in particular left ventricular (LV) volumetric status, and prediction of response. Despite its widespread applicability, LV volumes determined by echocardiography have inherent measurement errors, interobserver and intraobserver variability, and discrepancies with the gold standard magnetic resonance imaging. Echocardiographic predictors of CRT response are based on mechanical dyssynchrony. However, parameters are mainly tested in single-centre studies or lack feasibility. Speckle tracking echocardiography can guide LV lead placement, improving volumetric response and clinical outcome by guiding lead positioning towards the latest contracting segment. Results on optimisation of CRT device settings using echocardiographic indices have so far been rather disappointing, as results suffer from noise. Defining response by echocardiography seems valid, although re-assessment after 6 months is advisable, as patients can show both continuous improvement as well as deterioration after the initial response. Three-dimensional echocardiography is interesting for future implications, as it can determine volume, dyssynchrony and viability in a single recording, although image quality needs to be adequate. Deformation patterns from the septum and the derived parameters are promising, although validation in a multicentre trial is required. We conclude that echocardiography has a pivotal role in CRT, although clinicians should know its shortcomings.

Onze productaanbevelingen

Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Literatuur
Over dit artikel

Andere artikelen Uitgave 1/2016

Netherlands Heart Journal 1/2016 Naar de uitgave