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Abstract #1755

Identifying Patients for Cardiac Resynchronization Therapy Beyond Current Guidelines: Insights from Cardiac MRI

Di Zhou1 and Minjie Lu1
1Fuwai Hospital, Beijing, China

Synopsis

Keywords: Heart Failure, Tissue Characterization

Motivation: Nearly 30% of patients undergoing cardiac resynchronization therapy (CRT) according to Class I recommendations do not benefit, highlighting the need for improved patient selection methods.

Goal(s): This study aims to enhance risk stratification for CRT candidates with reduced ejection fraction and prolonged QRS by incorporating cardiac magnetic resonance (CMR) imaging factors beyond existing guidelines.

Approach: We retrospectively analyzed 711 patients who underwent CMR imaging. The primary endpoint was a composite of cardiac-related events.

Results: After a median follow-up of 4.8 years, late gadolinium enhancement (LGE) and left ventricular (LV) strains emerged as independent survival predictors, particularly influencing selection in Class IIa patients.

Impact: These findings suggest that integrating CMR imaging into clinical practice can significantly improve candidate selection for CRT, potentially increasing treatment efficacy.

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