Lazăr-Höcher Alexandra-Iulia, Cozma Dragoș, Cirin Liviu, Cozgarea Andreea, Faur-Grigori Adelina-Andreea, Catană Rafael, Tudose Dănuț George, Târtea Georgică, Crișan Simina, Gaiță Dan, Luca Constantin-Tudor, Văcărescu Cristina
Doctoral School, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania.
J Clin Med. 2024 May 25;13(11):3109. doi: 10.3390/jcm13113109.
Heart failure (HF) is a complex medical condition characterized by both electrical and mechanical dyssynchrony. Both dyssynchrony mechanisms are intricately linked together, but the current guidelines for cardiac resynchronization therapy (CRT) rely only on the electrical dyssynchrony criteria, such as the QRS complex duration. This possible inconsistency may result in undertreating eligible individuals who could benefit from CRT due to their mechanical dyssynchrony, even if they fail to fulfill the electrical criteria. The main objective of this literature review is to provide a comprehensive analysis of the practical value of echocardiography for the assessment of left ventricular (LV) dyssynchrony using parameters such as septal flash and apical rocking, which have proven their relevance in patient selection for CRT. The secondary objectives aim to offer an overview of the relationship between septal flash and apical rocking, to emphasize the primary drawbacks and benefits of using echocardiography for evaluation of septal flash and apical rocking, and to offer insights into potential clinical applications and future research directions in this area. Conclusion: there is an opportunity to render resynchronization therapy more effective for every individual; septal flash and apical rocking could be a very useful and straightforward echocardiography resource.
心力衰竭（HF）是一种复杂的医学病症，其特征为电和机械不同步。这两种不同步机制紧密相连，但目前的心脏再同步治疗（CRT）指南仅依赖电不同步标准，如QRS波时限。这种可能存在的不一致性可能导致符合条件的个体因机械不同步而无法接受CRT治疗，即使他们未满足电标准。本综述的主要目的是全面分析超声心动图对于使用室间隔闪烁和心尖摆动等参数评估左心室（LV）不同步的实用价值，这些参数已在CRT患者选择中证明了其相关性。次要目的旨在概述室间隔闪烁和心尖摆动之间的关系，强调使用超声心动图评估室间隔闪烁和心尖摆动的主要缺点和益处，并提供对该领域潜在临床应用和未来研究方向的见解。结论：有机会使再同步治疗对每个个体更有效；室间隔闪烁和心尖摆动可能是非常有用且直接的超声心动图资源。
