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CLINICAL RESEARCH: MRI AND RESYNCHRONIZATION

Magnetic Resonance Imaging Assessment of Ventricular Dyssynchrony

Current and Emerging Concepts

Division of Cardiology, Johns Hopkins University, Baltimore, Maryland

Manuscript received March 1, 2005; revised manuscript received August 26, 2005, accepted September 8, 2005.

^_* Reprint requests and correspondence: Dr. Albert C. Lardo, Johns Hopkins University, 720 Rutland Avenue, Ross 1042, Baltimore, Maryland 21205 (Email: alardo{at}jhmi.edu).

Despite the numerous documented benefits of cardiac resynchronization therapy (CRT), a significant proportion of patients undergoing CRT do not demonstrate symptomatic or morphologic improvement, triggering the search to improve targeting of this therapy. Many studies now support direct assessment of mechanical dyssynchrony as a method to better identify CRT responders. Among the methods used, echo-Doppler imaging has taken center stage and is covered in other articles in this special issue; however, these methods have several inherent limitations, and other alternatives are also being explored such as magnetic resonance imaging (MRI). This review discusses the concepts and clinical use of MRI methods for quantitative assessment of mechanical dyssynchrony, highlighting newer acquisition and analysis methods and focusing on how the data can be synthesized into robust indexes of dyssynchronous heart failure.

Abbreviations and Acronyms   CRT = cardiac resynchronization therapy   HARP = harmonic phase   MRI = magnetic resonance imaging   SENC = strain-encoded

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