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Imagerie cardiaque avant resynchronisation biventriculaire

Charlélie Erhart 1 Thibaut Lapotre 1 Nicolas Courtial 2 Pierre-Axel Lentz 1 Elise Bannier 3 Elena Galli 2, 1 Christophe Leclercq 2, 1 Erwan Donal 2, 1 Mathieu Lederlin 1, 2 
3 Empenn
INSERM - Institut National de la Santé et de la Recherche Médicale, Inria Rennes – Bretagne Atlantique , IRISA-D5 - SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE
Abstract : Cardiac Resynchronization Therapy (CRT) is part of the therapeutic armamentarium in end-stage heart failure. It consists in implanting two leads that synchronously stimulate the right and left ventricles and thus improve cardiac hemodynamics. To date, CRT is reserved for patients in sinus rhythm with LVEF < 35% and electrical ventricular dyssynchrony defined by a QRS > 150 ms and a left bundle branch block. However, 30 to 40% of the patients are non-responders to CRT, which suggests that the selection criteria can be improved. Currently, radiologists are requested in a pre-CRT work-up mainly to perform cardiac MRI and to quantify LVEF. However, the development of ultrasound, MRI and CT cardiac techniques, has made it possible to study new parameters that could improve the selection of patients and to hope for a better response rate to CRT. These parameters may be mechanical dyssynchrony, myocardial scar and interstitial fibrosis, or coronary venous anatomy. These data can be combined or even merged in order to stratify patients more precisely and/or to serve as a guide for CRT implantation. In this article, we propose to review the various imaging techniques, which, beyond the current guidelines, could help to refine patient selection and improve their response to CRT in the future.
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Submitted on : Thursday, June 24, 2021 - 9:22:50 AM
Last modification on : Friday, August 5, 2022 - 2:54:52 PM



Charlélie Erhart, Thibaut Lapotre, Nicolas Courtial, Pierre-Axel Lentz, Elise Bannier, et al.. Imagerie cardiaque avant resynchronisation biventriculaire. Journal d'imagerie diagnostique et interventionnelle, Elsevier, 2021, 4 (1), pp.56-65. ⟨10.1016/j.jidi.2020.08.002⟩. ⟨hal-03269457⟩



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