Figure 2.

Septal scar identifies non-responder to cardiac resynchronization therapy. (A) Strain traces (left), pressure-strain loops (middle), and regional work (right) in a representative non-responder (with non-ischaemic cardiomyopathy) prior to cardiac resynchronization therapy. Similar to the patient in the Take home figure, there are highly inefficient septal contractions with predominantly negative work (red-coloured pressure-strain loop area), which leads to a large lateral-to-septal work difference. (B) LGE-CMR revealed extensive septal scar with limited potential for recovery of septal function with cardiac resynchronization therapy. (C) After 6 months with cardiac resynchronization therapy, there is only moderate recovery of septal function and, despite reduced workload on the left ventricular lateral wall, still significant lateral-to-septal work difference. AVC, aortic valve closure; LGE-CMR, late gadolinium enhancement cardiac magnetic resonance; LVP, left ventricular pressure.