Abstract 16108: Adverse Left Ventricular Remodelling Patterns Predict Response to Cardiac Resynchronization Therapy
Introduction: The anatomy of the left ventricle (LV) remodels in heart failure. In this work we test the hypothesis that pre-implant LV shape can predict response to cardiac resynchronization therapy (CRT).
Methods: The anatomy of the LV of 50 subjects selected for CRT was acquired and manually segmented from magnetic resonance imaging acquired using a steady-state free-precision 3D sequence. A computational atlas was built from 3D meshes that were fitted to the resulting segmentations, and was used to obtain atlas-based shape metrics from the cohort. Segmentation and 3D meshing was repeated in 19 cases to test the reproducibility of the new metrics.
Results: The five most significant shape metrics were found to be reproducible. Response to CRT, defined as a reduction of a 10% in the end diastolic volume, was predicted by a linear combination of 2 atlas modes (AUC of 0.693, best operating point with sensitivity of 84% and specificity of 56%, as evaluated by a leave-1-out cross-validation test). The figure illustrates the overlay of the extreme geometry of responder (velvet) and non-responder (orange) shapes computed from the statistical shape model (the small red sphere is located at the septal wall): the adverse LV remodelling shows a shorter septal wall and angled basal plane.
Conclusions: Pre-implant LV shape, described through novel atlas-based metrics, is a potential new criterion for CRT patient selection.
Author Disclosures: G. Gonzalez: None. D. Warriner: None. T. Jackson: None. E. Sammut: None. E. Zacur: None. D. Hose: None. R. Razavi: None. N.P. Smith: None. P. Lamata: None.
- © 2015 by American Heart Association, Inc.