Imaging Predictive Factors and Exercise Training in CRT Patients

Detalhes bibliográficos
Autor(a) principal: Abreu, A
Data de Publicação: 2016
Outros Autores: Santa Clara, H
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.17/3827
Resumo: Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120msec or more on a 12-lead electrocardiogram (ECG). CRT improved functional capacity, reduced hospitalizations for worsening CHF and increased survival. However, about 30-40% of patients who underwent CRT were non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed. Cardiac magnetic resonance (CMR), recognized as the gold standard to assess viability, has shown to obtain good results regarding quantification of scar burden. CMR-derived measures of mechanical dyssynchrony appear to predict the outcome of CRT, however they have not been externally validated. Nuclear imaging techniques, namely single-photon emission cardiac tomography (SPECT) provide data on scar burden and location, left ventricular (LV) function, LV contraction and mechanical dyssynchrony from a single scan. The presence, location and burden of myocardial scar have been shown to affect response to CRT. However, compared to CMR, the low spatial resolution of scintigraphy might overestimate the scar extent. This problem can be overcome by positron emission tomography (PET). SPECT has also been used to quantify dyssynchrony, using phase analysis. Imaging investigation is ongoing, trying to better identifying CRT non-responders. The combination of ExT in CRT has not been well investigated; however some data show different aerobic exercise modes and intensities can further improve CRT benefits. Data available on the effects of ExT in patients with CRT have been reviewed.
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spelling Imaging Predictive Factors and Exercise Training in CRT PatientsHSM CARCardiac Resynchronization TherapyHumansEchocardiographyElectrocardiographyExercise / physiologyHeart Failure / diagnostic imagingHeart Failure / physiopathologyHeart Failure / rehabilitationPositron-Emission TomographyTomography, Emission-Computed, Single-PhotonTreatment OutcomeCardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120msec or more on a 12-lead electrocardiogram (ECG). CRT improved functional capacity, reduced hospitalizations for worsening CHF and increased survival. However, about 30-40% of patients who underwent CRT were non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed. Cardiac magnetic resonance (CMR), recognized as the gold standard to assess viability, has shown to obtain good results regarding quantification of scar burden. CMR-derived measures of mechanical dyssynchrony appear to predict the outcome of CRT, however they have not been externally validated. Nuclear imaging techniques, namely single-photon emission cardiac tomography (SPECT) provide data on scar burden and location, left ventricular (LV) function, LV contraction and mechanical dyssynchrony from a single scan. The presence, location and burden of myocardial scar have been shown to affect response to CRT. However, compared to CMR, the low spatial resolution of scintigraphy might overestimate the scar extent. This problem can be overcome by positron emission tomography (PET). SPECT has also been used to quantify dyssynchrony, using phase analysis. Imaging investigation is ongoing, trying to better identifying CRT non-responders. The combination of ExT in CRT has not been well investigated; however some data show different aerobic exercise modes and intensities can further improve CRT benefits. Data available on the effects of ExT in patients with CRT have been reviewed.Pime EditriceRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEAbreu, ASanta Clara, H2021-08-13T10:46:48Z20162016-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3827engMonaldi Arch Chest Dis. 2016 Oct 14;86(1-2):760.10.4081/monaldi.2016.760.info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:44:24Zoai:repositorio.chlc.min-saude.pt:10400.17/3827Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:21:08.530183Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Imaging Predictive Factors and Exercise Training in CRT Patients
title Imaging Predictive Factors and Exercise Training in CRT Patients
spellingShingle Imaging Predictive Factors and Exercise Training in CRT Patients
Abreu, A
HSM CAR
Cardiac Resynchronization Therapy
Humans
Echocardiography
Electrocardiography
Exercise / physiology
Heart Failure / diagnostic imaging
Heart Failure / physiopathology
Heart Failure / rehabilitation
Positron-Emission Tomography
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
title_short Imaging Predictive Factors and Exercise Training in CRT Patients
title_full Imaging Predictive Factors and Exercise Training in CRT Patients
title_fullStr Imaging Predictive Factors and Exercise Training in CRT Patients
title_full_unstemmed Imaging Predictive Factors and Exercise Training in CRT Patients
title_sort Imaging Predictive Factors and Exercise Training in CRT Patients
author Abreu, A
author_facet Abreu, A
Santa Clara, H
author_role author
author2 Santa Clara, H
author2_role author
dc.contributor.none.fl_str_mv Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE
dc.contributor.author.fl_str_mv Abreu, A
Santa Clara, H
dc.subject.por.fl_str_mv HSM CAR
Cardiac Resynchronization Therapy
Humans
Echocardiography
Electrocardiography
Exercise / physiology
Heart Failure / diagnostic imaging
Heart Failure / physiopathology
Heart Failure / rehabilitation
Positron-Emission Tomography
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
topic HSM CAR
Cardiac Resynchronization Therapy
Humans
Echocardiography
Electrocardiography
Exercise / physiology
Heart Failure / diagnostic imaging
Heart Failure / physiopathology
Heart Failure / rehabilitation
Positron-Emission Tomography
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
description Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120msec or more on a 12-lead electrocardiogram (ECG). CRT improved functional capacity, reduced hospitalizations for worsening CHF and increased survival. However, about 30-40% of patients who underwent CRT were non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed. Cardiac magnetic resonance (CMR), recognized as the gold standard to assess viability, has shown to obtain good results regarding quantification of scar burden. CMR-derived measures of mechanical dyssynchrony appear to predict the outcome of CRT, however they have not been externally validated. Nuclear imaging techniques, namely single-photon emission cardiac tomography (SPECT) provide data on scar burden and location, left ventricular (LV) function, LV contraction and mechanical dyssynchrony from a single scan. The presence, location and burden of myocardial scar have been shown to affect response to CRT. However, compared to CMR, the low spatial resolution of scintigraphy might overestimate the scar extent. This problem can be overcome by positron emission tomography (PET). SPECT has also been used to quantify dyssynchrony, using phase analysis. Imaging investigation is ongoing, trying to better identifying CRT non-responders. The combination of ExT in CRT has not been well investigated; however some data show different aerobic exercise modes and intensities can further improve CRT benefits. Data available on the effects of ExT in patients with CRT have been reviewed.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016-01-01T00:00:00Z
2021-08-13T10:46:48Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.17/3827
url http://hdl.handle.net/10400.17/3827
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Monaldi Arch Chest Dis. 2016 Oct 14;86(1-2):760.
10.4081/monaldi.2016.760.
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Pime Editrice
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dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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