Left intraventricular myocardial deformation dyssynchrony identifies responders to cardiac resynchronization therapy in patients with heart failure

Mele, Donato; Pasanisi, Giovanni; Capasso, Fabio; Simone, Antonio De; Morales, Maria‐Aurora; Poggio, Daniele; Capucci, Alessandro; Tabacchi, G; Sallusti, Luciano; Ferrari, Roberto

doi:10.1093/eurheartj/ehi814

Cited by 92 publications

(74 citation statements)

References 17 publications

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“…Patients were classi ed as responders if their LVEF increased by at least 20 , and/or the LVESV decreased by at least 15 with respect to baseline variations were considered as relative values . Patients were de ned as non-responders if they did not reach both of the above pre-speci ed echocardiographic changes 8 .…”

Section: Echocardiographic Evaluationmentioning

confidence: 99%

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy

:筆頭著者¹,

:責任著者²,

Yoshikawa³

et al. 2017

Showa Univ J Med Sci

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: Cardiac resynchronization therapy CRT is a well-established, ef cient strategy for medically-refractory congestive heart failure HF with ventricular conduction disturbances. However, about 30 of patients who undergo CRT do not receive any bene t. Therefore, we investigated the usefulness of the QRS-left ventricle LV interval for predicting responders during CRT implantation. This study included 66 patients who underwent CRT implantation. The de nition of responder was a ≥ 15 reduction in LV end-systolic volume or ≥ 20 increase in LV ejection fraction. The QRS-LV interval was measured from the beginning of the body surface electrocardiogram QRS complex to the LV potential recorded by LV leads. We analyzed the correlations between the QRS-LV intervals and CRT responders, admission for HF and mortality. The patients were 67 12 years old, and their mean LV ejection fraction was 26.3 8.3 . During follow-up 27.2 19.9 months , 27 patients were admitted for HF 40.1 , and 17 died 25.7 ; the median QRS-LV interval was 103 33 msec. Patients were divided into 2 groups: wide QRS-LV 103 msec , and narrow QRS-LV 103 msec . The wide QRS-LV group had a lower mortality rate than the narrow QRS-LV group 77 vs. 53 , P 0.05 . In patients with dilated cardiomyopathy, the QRS-LV interval was signi cantly wider in responders, compared to non-responders 112 9.2 vs. 80.0 10 msec, P 0.05 . The QRS-LV interval did not correlate with CRT responders or admission for HF. The mortality rate was lower in patients with wide QRS-LV intervals, compared to narrow QRS-LV intervals. Furthermore, a wide QRS-LV interval might be a predictor for CRT responders in patients with dilated cardiomyopathy.

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Section: Echocardiographic Evaluationmentioning

confidence: 99%

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy

:筆頭著者¹,

:責任著者²,

Yoshikawa³

et al. 2017

Showa Univ J Med Sci

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“…The initial results of dyssynchrony assessment using strain imaging have been conflicting, mainly regarding correlation with reverse remodelling (42,43). In a recent study, TDI Ts-SD in a 12-segment model predicted reverse remodelling with a sensitivity of 93% and a specificity of 73%, but correlation with strain was poor (44).…”

Section: Strain Strain Rate and Speckle Trackingmentioning

confidence: 99%

Patient assessment for cardiac resynchronization therapy: Past, present and future of imaging techniques

Auger

Ducharme

Harel

et al. 2010

Canadian Journal of Cardiology

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“…54 A delay Ͼ130 ms in time to peak radial strain in the anteroseptal and inferolateral walls predicted a short-term increase in stroke volume, 47 and the standard deviation in time to peak longitudinal strain among 12 basal and mid segments predicted reverse remodeling 6 months after CRT. 49 Using 2-dimensional speckle tracking, a delay Ͼ130 ms in time to peak systolic radial strain among 6 mid segments in the parasternal short-axis view (Figure 7) predicted increase in LVEF Ͼ15% with a sensitivity of 89% and a specificity of 83% at 8 months after CRT. 48 In contrast to these positive results, Yu and colleagues reported that standard deviation in time to peak systolic TDI-derived strain in 12 segments did not predict the response to CRT in 2 studies (a first study in 55 patients 42 and a second in 256 patients 43 ).…”

Section: Strain Imagingmentioning

confidence: 99%

Patient Selection and Echocardiographic Assessment of Dyssynchrony in Cardiac Resynchronization Therapy

et al. 2008

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A ppropriate cardiac resynchronization therapy (CRT) enhances quality of life and improves survival in patients with refractory heart failure due to systolic dysfunction and mechanical dyssynchrony. On the assumption that the main therapeutic mechanism of CRT is the correction of dyssynchronous myocardial contraction, imaging-based measures of dyssynchrony have been intensely investigated with the aim of predicting response to therapy. Numerous echocardiographic dyssynchrony parameters have been proposed, but no large prospective trial have been published to prove the clinical utility of any of these indexes. Moreover, the methodology to derive the proposed dyssynchrony indexes has not been standardized. Therefore, the purpose of this article is to critically review the current status of proposed dyssynchrony indexes by echocardiography for patient selection and to recommend future investigations in this area.

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Left intraventricular myocardial deformation dyssynchrony identifies responders to cardiac resynchronization therapy in patients with heart failure

Abstract: Patients with chronic HF should undergo ultrasound evaluation to quantify dyssynchrony of LV myocardial deformation, which would help identifying CRT responders.

Cited by 92 publications

References 17 publications

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy

Patient assessment for cardiac resynchronization therapy: Past, present and future of imaging techniques

Patient Selection and Echocardiographic Assessment of Dyssynchrony in Cardiac Resynchronization Therapy

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