Multimodality imaging in the characterization and risk-stratification of cardiac disease and CRT recipients

Abstract

In this thesis, i) the role of echocardiography in predicting outcome after cardiac resynchronization therapy (CRT) is investigated, as well as ii) the role of multimodality imaging in the risk-stratification of cardiac disease.

The relationship between baseline QRS duration and the presence of a left bundle branch block, and the degree of reverse left ventricular (LV) remodeling and improvement of LV ejection fraction (EF), is discussed in CRT recipients. Results are presented for the interaction of two key determinants of outcome after CRT, namely LV global longitudinal strain and LV reverse remodeling, as well as their impact on survival. The benefits of improved mechanical dyssynchrony (quantified with mechanical dispersion) after CRT are examined, as well as a novel, non-invasive technique for assessing myocardial work in CRT. The prognostic impact of functional mitral regurgitation (FMR) in CRT, and the impact of atrial fibrillation on FMR improvement, are discussed.

The role of cardiac imaging in the risk-stratification of genetic dilated cardiomyopathy is discussed, especially when associated with neuromuscular disorders. Specifically, the use of speckle tracking echocardiography in risk-stratification of genetic dilated cardiomyopathy was investigated.