Un-Answered Concerns Towards HER2 inhibitor Disclosed

LVEF is useful for predicting need for ICD but it is not clear if this is a property of ��reduced contractility�� or a reflection of ��degree of injury/scar��. Nevertheless, more precise methods of regional and global contractility (function), like deformation imaging (strain, strain rate etc), are being explored to predict SCD (Fig.?1). Myocardial strain curves quantify regional myocardial contraction, dispersion and timing, and are better than EF in predicting LV function as well as ventricular arrhythmias.23 Global longitudinal strain (GLS �C the average of peak negative strain of 16 left ventricular segments?greater than or equal to ?12% by speckle tracking) as well as mechanical dispersion which is a surrogate of electrical heterogeneity in the myocardium (SD of time from the peak of R-wave on electrocardiography to peak systolic find more strain in 16 left ventricular segments) have been found to be an independent predictor of arrhythmic events in prospective studies in large numbers of patients following acute myocardial infarction23,24; this was independent of and better than EF measurement.23 While low LVEF was associated Florfenicol with arrhythmic events it was not as good in patients with lesser degree of LV dysfunction while GLS was more predictive for arrhythmic events than LVEF while remaining useful also in patients with EF >35%.24 Combining GLS and mechanical dispersion (MD) improved predictability. GLS and MD might have a role in the early window post MI �C traditionally, ICD placement is not recommended in the first 40 days post MI since a benefit was not shown. However, there is a significant risk of SCD in this period. A recent study showed that GLS measured in the very early post MI period predicted long term SCD better than EF and other echo parameters. Interestingly, MD was difficult to evaluate in the peri MI period and failed to show additive benefit over GLS unlike in the period late after MI.25 GLS thus might be an important and easily obtainable parameter in predicting risk in patients early after MI, especially in those with EF >35% or those with EF HER2 overexpression Deformation imaging and risk of SCD. Top Panel: Normal individuals show little dispersion in peak myocardial strain timing but abnormal ventricles show significant mechanical dispersion that was prominent in patients with arrhythmias. Middle Panel: In ... Dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) have many similar final pathway mechanisms for SCD including scarring and mechano-electrical dys-synchrony; DCM is associated with SCD and patients with low EF are recommended for an ICD.