Abstract

Cardiac resynchronization has emerged as a highly effective therapy for heart failure. However, up to 40% of patients do not benefit from this treatment. In this Review, we discuss the potential role of MRI and nuclear molecular imaging in providing additional insights into the response to cardiac resynchronization therapy. Variables with potential prognostic and therapeutic values include the evaluation of cardiac dyssynchrony, scar, cardiac sympathetic function, myocardial blood flow, myocardial glucose and oxidative metabolism. Other molecular targets to characterize apoptosis, fatty acid metabolism, angiogenesis and angiotensin-converting enzyme activity will also be described. The potential use of these techniques in identifying and measuring responses to cardiac resynchronization therapy and future areas of research will be explored.

Author affiliations

N. R. Aggarwal, M. W. Martinez, B. J. Gersh & P Chareonthaitawee
The Department of Internal Medicine Mayo Clinic, Rochester, MN, USA (N. R. Aggarwal). The Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA (B. J. Gersh, P Chareonthaitawee). Division of Cardiology at Lehigh Valley Health Network and Penn State University, Allentown, PA, USA (M. W. Martinez).

Correspondence to: P Chareonthaitawee chareonthaitawee.panithaya@mayo.edu

Published online 3 November 2009