Response to cardiac resynchronization therapy

In the CRID-project (Contractile Reserve in Dyssynchrony) we aim to better identify patients who will benefit from so-called cardiac resynchronization therapy. These patients have problems with electrical activation of the heart muscle so that some regions of the muscle are electrically activated later than other regions (dyssynchrony). This can be corrected by implanting a pacemaker with electrodes placed in different regions. The pacemaker sends an electrical pulse to these electrodes, ensuring that the regions are activated simultaneously. However, about a third of the patients who receive this treatment do not get better. We aim to use newly developed imaging technologies to better characterize the patients who can benefit from this treatment.

Estimation of left ventricular filling pressure

Knowledge of the pressure in the left ventricle while it is filling, is important for making the correct diagnosis of heart failure and monitor treatment. Measurement of this pressure requires a pressure catheter to be inserted into the heart which is an expensive procedure with some associated risks, and hence it is performed in very few patients. The pressure can be estimated risk-free and much less costly by ultrasound imaging by looking at variables related to pressure such as flow velocities and cavity size. We are testing new imaging indices to improve the estimation of filling pressure in another ongoing project.

Heart function in congenital heart disease

Previously, children born with the heart disease “transposition of the great arteries” were treated by switching the great arteries so that the right heart pumps blood to the body and the left heart pumps blood to the lungs. This is the opposite of the normal circulation. Therefore, the right heart muscle has to adapt to pump against a high pressure. These adaptions may cause dysfunction of the heart muscle as these patients grow older. In this project the following is investigated and linked to risk for developing heart failure: a) function of the free wall in the right side of the heart, and b) function of the muscular wall (septum) that separates the right and left chambers of the heart.

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