Cerebroprotection mediated by angiotensin II

asynchrony were highly restrictive and may have led to selection of patients with a very unfavorable prognosis. Fourth, we agree with Dr. Gasparini and colleagues that the screening of patients suitable for CRT based on merely clinical criteria may be sufficient in specific settings. However, we are of the opinion that this simplification could increase the number of non-responders to CRT: this issue is critical, and current research for the identification of responders is in active development. There is evidence that left intraventricular asynchrony detected at echocardiography may represent the best parameter for the identification of responders to CRT (3,4). Therefore, we are convinced that the selection of patients for CRT should necessarily include the evaluation of mechanical asynchrony, the latter representing the pathophysiologic substrate for resynchronization pacing in heart failure patients.