Gerrits Willem, Danad Ibrahim, Velthuis Birgitta, Mushtaq Saima, Cramer Maarten J, van der Harst Pim, van Slochteren Frebus J, Meine Mathias, Suchá Dominika, Guglielmo Marco
Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
J Clin Med. 2023 Sep 26;12(19):6212. doi: 10.3390/jcm12196212.
Between 30-40% of patients with cardiac resynchronization therapy (CRT) do not show an improvement in left ventricular (LV) function. It is generally known that patient selection, LV lead implantation location, and device timing optimization are the three main factors that determine CRT response. Research has shown that image-guided CRT placement, which takes into account both anatomical and functional cardiac properties, positively affects the CRT response rate. In current clinical practice, a multimodality imaging approach comprised of echocardiography, cardiac magnetic resonance imaging, or nuclear medicine imaging is used to capture these features. However, with cardiac computed tomography (CT), one has an all-in-one acquisition method for both patient selection and the division of a patient-tailored, image-guided CRT placement strategy. This review discusses the applicability of CT in CRT patient identification, selection, and guided placement, offering insights into potential advancements in optimizing CRT outcomes.
接受心脏再同步治疗（CRT）的患者中，有30%至40%的患者左心室（LV）功能未得到改善。众所周知，患者选择、LV导联植入位置和设备时机优化是决定CRT反应的三个主要因素。研究表明，考虑到心脏解剖和功能特性的影像引导CRT植入，对CRT反应率有积极影响。在当前临床实践中，由超声心动图、心脏磁共振成像或核医学成像组成的多模态成像方法用于捕捉这些特征。然而，借助心脏计算机断层扫描（CT），人们有一种一体化的采集方法，可用于患者选择以及制定针对患者的影像引导CRT植入策略。本综述讨论了CT在CRT患者识别、选择和引导植入中的适用性，为优化CRT结果的潜在进展提供见解。
