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VIEWPOINT AND COMMENTARY

Mechanical Dyssynchrony in Congestive Heart Failure

Diagnostic and Therapeutic Implications

The Methodist DeBakey Heart Center, The Methodist Hospital, Houston, Texas.

Manuscript received August 15, 2007; accepted August 22, 2007.

^_* Reprint requests and correspondence: Dr. Sherif F. Nagueh, Methodist DeBakey Heart Center, 6550 Fannin, SM-677, Houston, Texas 77030. (Email: snagueh{at}tmh.tmc.edu).

Myocardial imaging has been successfully applied to the evaluation of patients with heart failure, particularly identifying candidates who are likely to respond to cardiac resynchronization therapy (CRT). Recent studies have shown the benefits of CRT in heart failure patients with depressed ejection fraction (EF) and a narrow QRS complex, albeit in a small number of patients, and without a placebo arm. In addition, few reports have noted the presence of pathophysiologically relevant mechanical dyssynchrony in patients with heart failure and normal EF. Collectively, these data support the need for a better understanding of cardiac function/dysfunction and its treatment in these patient groups.

Abbreviations and Acronyms   CRT = cardiac resynchronization therapy   DHF = diastolic heart failure   EF = ejection fraction   LV = left ventricle/ventricular   RV = right ventricle/ventricular

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