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Mechanical dyssynchrony: How do we measure it, what it means, and what we can do about it
- Source :
- Journal of Nuclear Cardiology. 28:2174-2184
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Left ventricular mechanical dyssynchrony (LVMD) is defined by a difference in the timing of mechanical contraction or relaxation between different segments of the left ventricle (LV). Mechanical dyssynchrony is distinct from electrical dyssynchrony as measured by QRS duration and has been of increasing interest due to its association with worse prognosis and potential role in patient selection for cardiac resynchronization therapy (CRT). Although echocardiography is the most used modality to assess LVMD, some limitations apply to this modality. Compared to echo-based modalities, nuclear imaging by gated single-photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI) has clear advantages in evaluating systolic and diastolic LVMD. GSPECT MPI can determine systolic and diastolic mechanical dyssynchrony by the variability in the timing in which different LV segments contract or relax, which has prognostic impact in patients with coronary artery disease and heart failure. As such, by targeting mechanical dyssynchrony instead of electrical dyssynchrony, GSPECT MPI can potentially improve patient selection for CRT. So far, few studies have investigated the role of diastolic dyssynchrony, but recent evidence seems to suggest high prevalence and more prognostic impact than previously recognized. In the present review, we provide an oversight of mechanical dyssynchrony.
- Subjects :
- medicine.medical_specialty
medicine.diagnostic_test
business.industry
medicine.medical_treatment
Cardiac resynchronization therapy
Cardiomyopathy
Diastole
030204 cardiovascular system & hematology
medicine.disease
030218 nuclear medicine & medical imaging
Coronary artery disease
03 medical and health sciences
QRS complex
Myocardial perfusion imaging
0302 clinical medicine
Heart failure
Internal medicine
medicine
Cardiology
Radiology, Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine
business
Emission computed tomography
Subjects
Details
- ISSN :
- 15326551 and 10713581
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Nuclear Cardiology
- Accession number :
- edsair.doi...........6f917dade28008acd0399de0af032d03