Comparison of Eight Echocardiographic Methods for Determining the Prevalence of Mechanical Dyssynchrony and Site of Latest Mechanical Contraction in Patients Scheduled for Cardiac Resynchronization Therapy

Faletra, Francesco F.; Conca, Cristina; Klersy, Catherine; Klimusina, Julija; Regoli, François; Mantovani, Antonio; Pasotti, Elena; Pedrazzini, Giovanni; Castro, S. De; Moccetti, Tiziano; Auricchio, Angelo

doi:10.1016/j.amjcard.2009.02.043

Cited by 31 publications

(22 citation statements)

References 24 publications

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“…A significantly better prognosis was found in patients with a substantial time delay between the antero-septal and posterior segments (≥130 ms). In spite of the methodological limits of the study, i.e., only radial strain to assess left ventricular dyssynchrony [49] and simple retrospective radiographical assessment of lead position, this study is the first which demonstrates how lead position, electro-mechanical delay, and presence of scar are inextricably linked and impact on the prognosis of CRT patients. Leyva et al [47] also showed that LV lead position inside the scar region results in a fivefold risk of pump failure and sudden cardiac death as compared to patients with no scar and patients with scar, but LV lead positioned elsewhere combined.…”

Section: Left Bundle Branch Blockmentioning

confidence: 99%

Electrical and Mechanical Ventricular Activation During Left Bundle Branch Block and Resynchronization

Strik

Regoli

Auricchio

et al. 2012

J. of Cardiovasc. Trans. Res.

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Cardiac resynchronization therapy (CRT) aims to treat selected heart failure patients suffering from conduction abnormalities with left bundle branch block (LBBB) as the culprit disease. LBBB remained largely underinvestigated until it became apparent that the amount of response to CRT was heterogeneous and that the therapy and underlying pathology were thus incompletely understood. In this review, current knowledge concerning activation in LBBB and during biventricular pacing will be explored and applied to current CRT practice, highlighting novel ways to better measure and treat the electrical substrate.

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Section: Left Bundle Branch Blockmentioning

confidence: 99%

Electrical and Mechanical Ventricular Activation During Left Bundle Branch Block and Resynchronization

Strik

Regoli

Auricchio

et al. 2012

J. of Cardiovasc. Trans. Res.

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“…However, in our study, we found no significant difference shortly after epirubicin administration evaluated by T LS-SD , T CS-SD and T RS-SD in adult patients. Speckle tracking echocardiography and real-time 3D echocardiography provide distinctly different measures of ventricular timing and cannot be considered directly comparable for assessing intraventricular dyssynchrony [21]. Furthermore, the cardiac damage induced by anthracycline progresses with time and young children are more susceptible to the injury.…”

Section: Beforementioning

confidence: 99%

Early detection of anthracycline-induced cardiotoxicity using two-dimensional speckle tracking echocardiography

Kang

Cheng²,

Li³

et al. 2013

Cardiol J

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day after completion of the therapy. Global and regional longitudinal (LS), circumferential (CS) and radial strain (RS), standard deviation of time to peak LS (T LS-SD ), CS (T CS-SD ), RS (T RS- p < 0.01) and RS (39.95 ± 5.79% vs. 36.15 ± 5.79%, p < 0.01 ), were remarkably reduced compared to baseline values. However, T LS-SD , T CS-SD and T RS-SD showed no significant difference after epirubicin exposure. Hypertension was an independent predictor of reduction of global LS, CS and RS.Conclusions: Subtle abnormalities in myocardial systolic function were present in asymptomatic patients shortly after anthracycline exposure, which could be detected by 2D speckle tracking echocardiography. (Cardiol J 2013; 20, 6: 592-599)

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“…Among 193 possible combinations of methods and walls, there was no agreement among methods in detecting the site of latest contraction in 77%, agreement between 2 of the 3 methods in 21%, and agreement between all 3 methods in only 4 instances (2%). Given the almost 100% sensitivity of 3DE and ST, the investigators question their additional value beyond a prolonged QRS (14). Despite the controversy over the value of echo Doppler measures of DYS and their ability to predict response to CRT, the value of these methods in assessing morphologic and functional changes following CRT remains unquestioned.…”

Section: Cardiac Resynchronization Therapymentioning

confidence: 97%

“…To further complicate this issue, Faletra et al (14) compared the prevalence of DYS and the site of latest LV activation reported by 8 different echocardiographic methods (TDI: n ϭ 4, ST: n ϭ 3, and 3DE) in 63 HF patients scheduled for CRT. Feasibility was generally good ranging for 100% for longitudinal ST to 71% for radial ST.…”

Section: Cardiac Resynchronization Therapymentioning

confidence: 98%

The Year in Echocardiography

Weyman

2010

Journal of the American College of Cardiology

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The reassessment and re-evaluation that have characterized echocardiographic research for the past 2 years have led to reaction and controversy in 2 areas of recent interest. First, the role of echo Doppler techniques in the evaluation of diastolic function, particularly the accuracy of the E/e= ratio in assessing left atrial pressure, has been questioned and has prompted study of the physiologic determinants of the tissue Doppler rapid filling wave. Second, there has been a flurry of response to the results of the PROSPECT (Predictors of Response to CRT) trial that questioned the value of echo Doppler indexes in defining left ventricular (LV) dyssynchrony (DYS) and predicting response to cardiac resynchronization therapy (CRT). In the area of valvular heart disease, 3-dimensional echo (3DE) studies have demonstrated mitral leaflet morphologic adaptation to chronic tethering and led to an understanding of the cellular mechanisms underlying these responses. New insights were also reported in a variety of other areas including the prognostic value of echo Doppler measures of LV function in the general population, the impact of contrast echo on clinical decision making in patients with technically difficult studies, 3-dimensional speckle tracking, and the utility of delayed diastolic relaxation following stress echo as a marker of prior ischemia. Diastolic FunctionThe E/e= ratio in predicting left atrial pressure: questions of accuracy. The E/e= ratio has been proposed as a reliable estimate of LV filling pressure because the E wave velocity depends on left atrial (LA) pressure, residual relaxation pressure, and age; e= is presumed to depend only on LV relaxation and age. Therefore, according to this theory, dividing E/e= should eliminate relaxation pressure and age and thus become a noninvasive estimate of LA pressure (1). However, several recent papers have raised questions about the reliability of tissue Doppler imaging (TDI) measures of LV relaxation as markers of LA pressure or diastolic function. Geske et al.(2) failed to show a significant correlation between simultaneous LA pressure and medial E/e= in a group of patients with hypertrophic cardiomyopathy (r 2 ϭ 0.07, p ϭ 0.07). Mullens et al. (3) found no significant correlation between pulmonary capillary wedge pressure (PCWP) and mitral e= in either the septal or lateral annulus or when averaged over both annular regions in a group of patients with advanced heart failure (r ϭ 0.18, p ϭ 0.07). Further, when patients were divided into those with E/e= ratios Ͻ8, 8 to 15, and Ͼ15, PCWPs were similar for each group (19 Ϯ 4 mm Hg, 19 Ϯ 7 mm Hg, and 20 Ϯ 6 mm Hg, respectively). Follow-up studies were obtained in 49% of patients and there was no correlation between absolute change in PCWP and change in mitral E/e= ratio and the investigators cautioned against the direct inference of such relationships in patients with significant LV systolic dysfunction, cardiac remodeling, or biventricular pacing (3). In an experimental study, Masutani et al. (4) reported that d...

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Comparison of Eight Echocardiographic Methods for Determining the Prevalence of Mechanical Dyssynchrony and Site of Latest Mechanical Contraction in Patients Scheduled for Cardiac Resynchronization Therapy

Cited by 31 publications

References 24 publications

Electrical and Mechanical Ventricular Activation During Left Bundle Branch Block and Resynchronization

Electrical and Mechanical Ventricular Activation During Left Bundle Branch Block and Resynchronization

Early detection of anthracycline-induced cardiotoxicity using two-dimensional speckle tracking echocardiography

The Year in Echocardiography

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