Медицинская литература. Новинки

 

 

 

 

 

 

Возможности магнитно-резонансной томографии сердца при отборе кандидатов на сердечную ресинхронизирующую терапию

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Сердечная ресинхронизирующая терапия (СРТ) - современный и признанный метод лечения пациентов с симптомной хронической сердечной недостаточностью с тяжелой систолической дисфункцией левого желудочка (ЛЖ) и расширенным комплексом QRS (> 150 мс). Эффективность СРТ, так же как любого метода лечения, вариабельна. Известно, что выраженность и локализация рубцовых изменений, их расположение по отношению к стимулируемой области ЛЖ могут вносить вклад в успех СРТ. Помимо оценки глобальной и локальной сократимости сердца, изучения коронарной анатомии, с помощью МРТ сердца возможны изучение локализации и количественная оценка рубцовых изменений. В данном обзоре освещены возможности МРТ сердца в обследовании кандидатов на СРТ с акцентом на стратификацию риска и расположение право- и левожелудочковых электродов.

Ключевые слова:
сердечная ресинхронизирующая терапия, магнитно-резонансная томография сердца, сердечная недостаточность, cardiac resynchronization therapy, cardiovascular magnetic resonance, heart failure

Литература:
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Possibilities of cardiac magnetic resonance in selection of candidates for cardiac resynchronization therapy

Cardiac resynchronization therapy (CRT) is a contemporary and established treatment for patients with symptomatic heart failure, severely impaired left ventricular (LV) systolic dysfunction and a wide (>150 ms) complex. As with any other treatment, the response to CRT is variable. The degree of preimplant scar burden and scar localization to the vicinity of the LV pacing stimulus are known to influence response and outcome. As well as providing measurements of global and segmental cardiac function, coronary venograghy, CMR also permits localization and quantification of myocardial perfusion and scars. This review explores on the role of CMR in the assessment of patients undergoing CRT, with emphasis on risk stratification and RV and LV leads deployment.

Keywords:
сердечная ресинхронизирующая терапия, магнитно-резонансная томография сердца, сердечная недостаточность, cardiac resynchronization therapy, cardiovascular magnetic resonance, heart failure