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07 Dec 2012

Outcome analysis in cardiovascular imaging 

Topics: Non-invasive imaging: Echocardiography, MR/CT, Nuclear
Session number: 105
Session title: Outcome analysis in cardiovascular imaging
Authors: Doctor Georgios Karatasakis

The significance of cardiovascular imaging in terms of its effects on patient outcome was analyzed through a comprehensive review of the current literature and complete elucidation of the terms used to describe prognostic implications. Importantly, the presenter made the important distinction between prognosis and outcome. It was also pointed out that excessive use of imaging techniques, despite their prognostic importance, can even be detrimental to patient outcome, not only because of radiation exposure and time delay, but also because it may produce diagnostic deviation and erroneous decision-making.

The echocardiographic expression of dyssynergy was analyzed in combination with a detailed review of previous studies, which failed to show a significant impact of echocardiography in identifying patients who would respond to cardiac resynchronization therapy (CRT). The speaker focused his presentation on a newly proposed index, namely ”apical rocking” which describes the rocking motion of the apex in patients who become responders and improve their left ventricular function and functional capacity after CRT.

The importance of optimal medical treatment for outcome and the effect of beta blockade on stress echocardiography test results was also analyzed. The speaker explained that beta blockade improves regional myocardial flow and function during exercise. Furthermore, beta blockers improve coronary flow reserve in hypertensive patients and left ventricular function and perfusion in patients with idiopathic dilated cardiomyopathy.

The combination of coronary flow reserve information with contractile reserve information may lead to less diagnostic pitfalls in coronary artery disease patients.

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.