Contractile Reserve in Dyssynchrony: A Novel Principle to Identify Candidates for Cardiac Resynchronization Therapy

Conditions

Cardiomyopathy, Heart Failure

Brief summary

Cardiac resynchronisation therapy (CRT) has been documented to be a powerful treatment in patients with severe congestive heart failure. However, 30-40% of patients receiving a CRT are non-responders. In this study the investigators will use a previously validated method to estimate myocardial segment work non-invasively by speckle-tracking echocardiography and blood pressure. Furthermore, cardiac magnetic resonance imaging (CMR) with late gadolinium enhancement (LGE) will be performed in feasible subjects. The main purpose of the study is to determine if myocardial work by echocardiography in combination with viability assessment by LGE-CMR can predict response to CRT.

Hammersboen LR, Stugaard M, Puvrez A, Larsen CK, Remme EW, Kongsgård E, Duchenne J, Galli E, Khan FH, Sletten OJ, Penicka M, Donal E, Voigt JU, Smiseth OA, Aalen JM.

2024-11-206 citations

10.1016/j.jcmg.2024.09.008

Scar imaging in the dyssynchronous left ventricle: Accuracy of myocardial metabolism by positron emission tomography and function by echocardiographic strain.

Larsen CK, Galli E, Duchenne J, Aalen JM, Stokke C, Fjeld JG, Degtiarova G, Claus P, Gheysens O, Saberniak J, Sirnes PA, Lyseggen E, Bogaert J, Kongsgaard E, Penicka M, Voigt JU, Donal E, Hopp E, Smiseth OA.

2022-11-295 citations

10.1016/j.ijcard.2022.11.042

Mechanical Effects on Right Ventricular Function From Left Bundle Branch Block and Cardiac Resynchronization Therapy.

Storsten P, Aalen JM, Boe E, Remme EW, Gjesdal O, Larsen CK, Andersen ØS, Eriksen M, Kongsgaard E, Duchenne J, Voigt JU, Smiseth OA, Skulstad H.

2020-01-1512 citations

10.1016/j.jcmg.2019.11.016

Interventions

OTHERDiagnostic interventions; PET, MRI, cardiac ultrasound.

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Subject is indicated for CRT device according to European Society of Cardiology (ESC) guidelines from 2013. * Subject is willing to sign informed consent form and is 18 years or older.

Exclusion criteria

* Right bundle branch block. * Recent myocardial infarction, within 40 days prior to enrollment. * Subject underwent coronary artery bypass graft (CABG) or valve surgery, within 90 days. * Post heart transplantation, or is actively listed on the transplantation list, or has reasonable probability (per investigator's discretion) of undergoing transplantation in the next year * Implanted with a LV assist device (LVAD), or has reasonable probability (per investigator's discretion) of receiving a LVAD in the next year * Severe aortic stenosis (with a valve area of \<1.0 cm2 or significant valve disease expected to be operated on within study period). * Complex and uncorrected congenital heart disease. * Breastfeeding women or women of child bearing potential. * Enrolled in one or more concurrent studies that would confound the results of this study. * Impossible to obtain LV volumes by echocardiography

Design outcomes

Primary

Measure	Time frame	Description
Reverse remodelling at 6 months follow-up	6 months	Measured by left ventricular end-systolic volume reduction of at least 15% assessed by echocardiography

Secondary

Measure	Time frame	Description
New York Heart Association (NYHA) Class Changes	6 months	—
Heart failure hospitalizations	12 months	—
Death of any cause	5 years	—
Quality of Life Changes	6 months	Changes in quality of life measured by the Minnesota Living With Heart Failure Questionnaire
Left atrial contractile synchrony	2 years	—
Reverse remodelling at 12 months follow-up	12 months	Measured by left ventricular end-systolic volume reduction of at least 15% assessed by echocardiography
Heart transplantation	5 years	—

Countries

Belgium, Norway

Outcome results

None listed