COMPOSITIONS, DEVICES AND METHODS FOR DIAGNOSING HEART FAILURE AND FOR PATIENT-SPECIFIC MODELING TO PREDICT OUTCOMES OF CARDIAC RESYNCHRONIZATION THERAPY

摘要

in alternative embodiments, provided are compositions, medical devices or products of manufacture, systems, diagnostic tools, and methods, including computer implemented methods, for predicting the response of patients with dyssynchronous heart 10 failure (DHF) to cardiac resynchronization therapy (CRT), comprising: measuring or determining the fraction of the LV/septum performing negative work (MNW); and measuring or determining the coefficient of variation of external work density (COVW), wherein the MNW fraction performing negative work and coefficient of variation COVW (sd/mean) correlated strongly with observed reduction in end-systolic volume after CRT.

主权项

1. A method comprising:
predicting and optimizing the response of patients with dyssynchronous heart failure (DHF) to cardiac resynchronization therapy (CRT), and/or diagnosing dyssynchronous heart failure or the degree of dyssynchrony in dyssynchronous heart failure, comprising:
measuring or determining indices derived from the regional distribution of myocardial external work density (RDMW) prior to treatment as a diagnostic assessment of the severity of dyssynchronous heart failure or the adverse impact of dyssynchrony on ventricular mechanical performance, wherein the indices measured or determined are selected from the group consisting of:(i) the fraction of ventricular wall mass or volume, or a part thereof, left ventricle (LV), right ventricle (RV), or septum, performing negative work (myocardial negative work density fraction, or MNWF), having work done on it by the surrounding heart wall,(ii) regions of the left ventricular wall mass performing negative work (LVNW),(iii) the coefficient of variation of external work density (COVW) or other measures of work dispersion or heterogeneity, to predict amount of electromechanical dyssynchrony or the likely improvement in CRT response,(iv) the fraction of the septal wall performing negative work, wherein a decrease in the fraction of the septal wall performing negative work computed after simulated CRT is a predictor of pump function improvement and CRT response, and(v) a combination thereof.