Comparison of the measured pre‐ejection periods and left ventricular ejection times between echocardiography and impedance cardiography for optimizing cardiac resynchronization therapy

Noda, Kazuki; Endo, Hideki; Kadosaka, Takahide; Nakata, Takashi; Watanabe, Tasuku; Terui, Yosuke; Kajitani, Shoko; Monnma, Yuto; Sato, Kenjiro; Kanazawa, Masanori; Nakajima, Shuro; Kondo, Masateru; Takahashi, Tohru; Nakamura, Akihiro; Nozaki, Eiji

doi:10.1016/j.joa.2016.08.003

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…Echocardiography is a standard modality extensively used in clinical settings for a variety of diagnostic purposes. However, its accuracy in finding the exact instant of valve opening or closing, besides being affected by noise and operator variability, as mentioned in the background section, it is also limited by the resolution of the captured frame and its poor synchrony with the ECG (Noda et al, 2017). To overcome these imprecisions, we proposed a new protocol for recording and labeling the echocardiogram images by performing a multimodal echocardiographic procedure and considering time windows for the assessment of the valve openings and closures.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Different Methods for Estimating Cardiac Timings: A Comprehensive Multimodal Echocardiography Investigation

Dehkordi

Khosrow-Khavar²,

Rienzo

et al. 2019

Front. Physiol.

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Cardiac time intervals are important hemodynamic indices and provide information about left ventricular performance. Phonocardiography (PCG), impedance cardiography (ICG), and recently, seismocardiography (SCG) have been unobtrusive methods of choice for detection of cardiac time intervals and have potentials to be integrated into wearable devices. The main purpose of this study was to investigate the accuracy and precision of beat-to-beat extraction of cardiac timings from the PCG, ICG and SCG recordings in comparison to multimodal echocardiography (Doppler, TDI, and M-mode) as the gold clinical standard. Recordings were obtained from 86 healthy adults and in total 2,120 cardiac cycles were analyzed. For estimation of the pre-ejection period (PEP), 43% of ICG annotations fell in the corresponding echocardiography ranges while this was 86% for SCG. For estimation of the total systolic time (TST), these numbers were 43, 80, and 90% for ICG, PCG, and SCG, respectively. In summary, SCG and PCG signals provided an acceptable accuracy and precision in estimating cardiac timings, as compared to ICG.

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Section: Methodsmentioning

confidence: 99%

Comparison of Different Methods for Estimating Cardiac Timings: A Comprehensive Multimodal Echocardiography Investigation

Dehkordi

Khosrow-Khavar²,

Rienzo

et al. 2019

Front. Physiol.

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“…Moreover, Seery et al showed that PEP can be calculated using the R-wave instead of the Q-wave [ 15 ]. PEP can be considered as a measure of left ventricular function, as it reflects changes in the contractility of myocardium, left ventricular end-diastolic volume, and aortic diastolic pressure [ 13 , 16 – 18 ]. In patients with diabetic chronic kidney disease, fluid overload is a marker for left ventricular systolic dysfunction and is associated with the ratio of brachial PEP and brachial ejection time [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Small intra-individual variability of the pre-ejection period justifies the use of pulse transit time as approximation of the vascular transit

Kortekaas¹,

Velzen²,

Grüne³

et al. 2018

PLoS ONE

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BackgroundVascular transit time (VTT) is the propagation time of a pulse wave through an artery; it is a measure for arterial stiffness. Because reliable non-invasive VTT measurements are difficult, as an alternative we measure pulse transit time (PTT). PTT is defined as the time between the R-wave on electrocardiogram and arrival of the resulting pulse wave in a distal location measured with photoplethysmography (PPG). The time between electrical activation of the ventricles and the resulting pulse wave after opening of the aortic valve is called the pre-ejection period (PEP), a component of PTT. The aim of this study was to estimate the variability of PEP at rest, to establish how accurate PTT is as approximation of VTT.MethodsPTT was measured and PEP was assessed with echocardiography (gold standard) in three groups of 20 volunteers: 1) a control group without cardiovascular disease aged <50 years and 2) aged >50 years, and 3) a group with cardiovascular risk factors, defined as arterial hypertension, dyslipidemia, kidney failure and diabetes mellitus.ResultsPer group, the mean PEP was: 1) 58.5 ± 13.0 ms, 2) 52.4 ± 11.9 ms, and 3) 57.6 ± 11.6 ms. However, per individual the standard deviation was much smaller, i.e. 1) 2.0–5.9 ms, 2) 2.8–5.1 ms, and 3) 1.6–12.0 ms, respectively. There was no significant difference in the mean PEP of the 3 groups (p = 0.236).ConclusionIn conclusion, the intra-individual variability of PEP is small. A change in PTT in a person at rest is most probably the result of a change in VTT rather than of PEP. Thus, PTT at rest is an easy, non-invasive and accurate approximation of VTT for monitoring arterial stiffness.

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“…In addition, there are other optimization methods which could be used in combination with echocardiography. Noda et al reported that PEP/left ventricular ejection time (LVET) calculations by impedance cardiography (ICG) and echocardiography were positively correlated [ 56 ]. Thus, ICG could be useful in combination with echocardiography for CRT optimization.…”

Section: Resultsmentioning

confidence: 99%

The Role of Echocardiography in the Optimization of Cardiac Resynchronization Therapy: Current Evidence and Future Perspectives

Spartalis¹,

Tzatzaki²,

Spartalis³

et al. 2017

TOCMJ

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Background:Cardiac resynchronization therapy (CRT) has become a mainstay in the management of heart failure. Up to one-third of patients who received resynchronization devices do not experience the full benefits of CRT. The clinical factors influencing the likelihood to respond to the therapy are wide QRS complex, left bundle branch block, female gender, non-ischaemic cardiomyopathy (highest responders), male gender, ischaemic cardiomyopathy (moderate responders) and narrow QRS complex, non-left bundle branch block (lowest, non-responders). Objective:This review provides a conceptual description of the role of echocardiography in the optimization of CRT. Method:A literature survey was performed using PubMed database search to gather information regarding CRT and echocardiography. Results:A total of 70 studies met selection criteria for inclusion in the review. Echocardiography helps in the initial selection of the patients with dyssynchrony, which will benefit the most from optimal biventricular pacing and provides a guide to left ventricular (LV) lead placement during implantation. Different echocardiographic parameters have shown promise and can offer the possibility of patient selection, response prediction, lead placement optimization strategies and optimization of device configurations. Conclusion:LV ejection fraction along with specific electrocardiographic criteria remains the cornerstone of CRT patient selection. Echocardiography is a non-invasive, cost-effective, highly reproducible method with certain limitations and accuracy that is affected by measurement errors. Echocardiography can assist with the identification of the appropriate electromechanical substrate of CRT response and LV lead placement. The targeted approach can improve the haemodynamic response, as also the patient-specific parameters estimation.

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Comparison of the measured pre‐ejection periods and left ventricular ejection times between echocardiography and impedance cardiography for optimizing cardiac resynchronization therapy

Cited by 11 publications

References 12 publications

Comparison of Different Methods for Estimating Cardiac Timings: A Comprehensive Multimodal Echocardiography Investigation

Comparison of Different Methods for Estimating Cardiac Timings: A Comprehensive Multimodal Echocardiography Investigation

Small intra-individual variability of the pre-ejection period justifies the use of pulse transit time as approximation of the vascular transit

The Role of Echocardiography in the Optimization of Cardiac Resynchronization Therapy: Current Evidence and Future Perspectives

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