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Is echo still useful for resynchronisation therapy?

  • Accuracy of echo in identifying dyssynchrony and responders in routine, presented by P Sogaard (Hellerup, DK)  
  • New echocardiographic parameters to identify responders to cardiac resynchronisation therapy, presented by M Vannan (Columbus, US)  
  • The role of scar: from echo to cardiac MRI, presented by N Van De Veire (Gent, BE)  
  • Reverse remodelling in patients with NYHA I-II classes, presented by M St John Sutton (Philadelphia, US)  
  • Emerging outcome-based evidence for echo in CRT, presented by J Gorcsan (Pittsburgh, US)


The session focused on the need for adequate training to obtain the necessary level of Doppler Tissue Imaging as a method to accurately and reproducibly measure mechanical dyssynchrony.

Dr Mani Vannan’s presentation provided some insights into a “newer” approach where mechanical dis-coordination of the entire left ventricle measured automatically from a volume (echo) data, similar to CURE index by CMR, may potentially be an imaging-based target to predict response/no-response to CRT. The role of venous anatomy and myocardial scar burden in determining the success of CRT was reviewed by Dr Nico Van de Veire. Dr Martin St. John Sutton presented emerging data from clinical studies supporting the expanding use of CRT in mild-moderate HF. Dr John Gorcsan then presented a comprehensive review of the data, new and old, which highlighted the role of mechanical dyssynchrony measured by echocardiography as an emerging predictor of outcome in the HF population with and without CRT.

Conclusion:


The content of the session was comprehensive. A panel discussion to tease out what is the current role of imaging practice and the controversies underlying what we measure added to the value of the session. Given that CRT has become “standard” device therapy and the costs associated with it are considerable, imaging may in fact aid in optimal selection (over and above the clinical/EKG profile) to enhance the outcomes. This latter issue has been extensively talked and written about, but it needs a meaningful clarification of the everyday practitioner. An expert panel discussion with “real-life” case presentations would be helpful.

References


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Is echo still useful for resynchronisation therapy?

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.

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