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J Am Coll Cardiol, 2006; 48:1953-1960, doi:10.1016/j.jacc.2006.07.046 (Published online 31 October 2006).
© 2006 by the American College of Cardiology Foundation
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Delayed Enhancement Magnetic Resonance Imaging Predicts Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Dyssynchrony

James A. White, MD*, Raymond Yee, MD*,*, Xiaping Yuan, PhD{dagger}, Andrew Krahn, MD*, Allan Skanes, MD*, Michele Parker, MS{ddagger}, George Klein, MD* and Maria Drangova, PhD{dagger},§

* Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada
{dagger} Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
{ddagger} Duke Cardiac Magnetic Resonance Center, Duke University Medical Center, Durham, North Carolina
§ Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.


Figure 1
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  		Figure 1 Short-axis delayed-enhancement magnetic resonance image showing a large area of scarred (bright) myocardium in the septal, anteroseptal, and anterior walls. Area planimetry of viable myocardium (red line) and scarred myocardium (yellow line) was performed as illustrated.

 

Figure 2
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  		Figure 2 Examples of scar distribution (bright signal) on delayed-enhancement magnetic resonance imaging from clinical nonresponders (top row), responders without scar (middle row), and responders with scar (bottom row).

 

Figure 3
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  		Figure 3 Typical scar patterns seen on delayed-enhancement magnetic resonance imaging in clinical responders with (A) history of myocardial infarction and (B) no history of myocardial infarction (scar indicated by white arrows).

 

Figure 4
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  		Figure 4 Receiver-operating characteristic analysis of total percent scar for the prediction of clinical response to cardiac resynchronization therapy.

 

Figure 5
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  		Figure 5 Linear regression plots showing the relationship between total percent scar and change in (A) left ventricular ejection fraction (EF), (B) quality-of-life (QOL) score, (C) 6-min walk, and (D) New York Heart Association (NYHA) functional class at follow-up.

 




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