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Updated: Sep 26, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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Relationship Between Left Ventricular Strain Assessment by Cardiac Magnetic Resonance Imaging and Response to Cardiac

Abhishek Rathi1, Lauren Kanee2, Maude Limoges3

  • 1Department of Medical Imaging.

Journal of Thoracic Imaging
|April 19, 2022
PubMed

Insights

Cardiac MRI strain and scar imaging may predict response to cardiac resynchronization therapy (CRT) in heart failure patients. These non-invasive measures correlate with positive remodeling, guiding potential CRT treatment decisions.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Heart Failure Research

Background:

  • Cardiac resynchronization therapy (CRT) is a key treatment for heart failure with reduced ejection fraction.
  • A significant proportion of patients (30-50%) do not respond effectively to CRT.

Purpose of the Study:

  • To investigate if cardiac magnetic resonance (CMR) derived global left ventricular (LV) strain and late gadolinium enhancement (LGE) can predict reverse LV remodeling in response to CRT.
  • To assess the utility of pre-implant CMR parameters in identifying CRT responders.

Main Methods:

  • Retrospective analysis of 19 patients undergoing CRT.
  • Pre-CRT cardiac MRI to measure global LV strain and LGE by a blinded reader.
  • Transthoracic echocardiography to assess LV reverse remodeling (LV volume reduction, ejection fraction improvement) pre- and post-CRT.

Main Results:

  • Both global LV strain and the extent of LGE showed a significant correlation with measures of reverse LV remodeling.
  • These CMR-derived parameters were independently associated with positive treatment response.

Conclusions:

  • CMR-derived strain analysis and scar evaluation show potential as pre-implant predictors of CRT response.
  • Further large-scale, prospective, multi-center studies are warranted to validate these findings and integrate CMR strain imaging into CRT treatment guidance.

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