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Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Related Experiment Video

Updated: May 6, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
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Three-dimensional echocardiographic optimization improves outcome in cardiac resynchronization therapy compared to

Carolin Sonne1, Lorenz Bott-Flugel, Simon Hauck

  • 1Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.

Pacing and Clinical Electrophysiology : PACE
|October 30, 2013
PubMed
Summary

Novel echocardiography optimization significantly improves cardiac resynchronization therapy (CRT) outcomes. This method enhances response rates and left ventricular function compared to electrocardiogram (ECG) optimization.

Keywords:
3D echocardiographycardiac resynchronization therapydyssynchronyoptimization

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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Optimal atrioventricular (AV) and ventricular-ventricular (VV) intervals for cardiac resynchronization therapy (CRT) lack consensus.
  • Conventional electrocardiogram (ECG) optimization may not be sufficient for individualizing CRT parameters.

Purpose of the Study:

  • To evaluate a novel optimization protocol using Doppler echocardiography (DE) and three-dimensional echocardiography (3DE).
  • To compare the efficacy of echocardiographic optimization versus ECG optimization for AV and VV intervals in CRT patients.

Main Methods:

  • A double-blind, randomized controlled trial involving 77 patients with heart failure and wide QRS.
  • Patients were randomized to DE/3DE-guided optimization or ECG-guided optimization.
  • Left ventricular (LV) dimensions, ejection fraction (EF), and systolic dyssynchrony index (SDI) were assessed using 3DE.

Main Results:

  • Significantly higher clinical response rates in the echocardiography group (82%) compared to the ECG group (58%).
  • Greater improvements in EF (7.0% vs 3.4%) and reduction in SDI (-4.5% vs -1.5%) were observed with echocardiographic optimization.
  • The echocardiographic approach demonstrated superior outcomes in key cardiac function metrics.

Conclusions:

  • Echocardiographic optimization using DE and 3DE is superior to ECG optimization for CRT.
  • This novel protocol leads to higher response rates and improved LV systolic function.
  • Individualized AV and VV interval selection via echocardiography can enhance CRT efficacy.