The identification of heart failure patients prone to benefit from cardiac resynchronisation therapy

Cardiac resynchronisation therapy (CRT) is widely considered a relevant therapeutic option for patients with severe heart failure (HF) and left intraventricular conduction delay with wide QRS interval, still symptomatic despite receiving "optimal" medical treatment. Beneficial effects including improvement in hemodynamic status as well as in exercise tolerance, quality of life, hospitalization and mortality rate have been documented after CRT. However, up to 30% of patients receiving a CRT device do not benefit from it. This is why a number of parameters have been investigated to identify patients who benefit from CRT, and, among them, echo - Doppler-derived measures of dyssynchrony have received great attention. The interest towards these parameters comes from the fact that they can be easily obtained. Mono-dimensional echocardiographic measures of left ventricular asyncrony has demonstrated to predict reverse remodeling as well as a better outcome in terms of heart failure worsening.