Regional myocardial contractile reserve assessed by strain echocardiography and the response to cardiac resynchronization therapy

Mitro, Peter; Murín, Pavol; Valočík, Gabriel; Šimurda, Miloš

doi:10.5603/cj.a2014.0003

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…Studies have used a variety of different imaging modalities and techniques to measure contractile reserve [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Interpretation of studies is difficult due to multiple different definitions of response; these include clinical assessment of functional capacity (New York Heart Association Class), echocardiographic measures of left ventricular remodeling/performance (LV size, volume or ejection fraction) and prognostic markers (heart failure admissions, freedom from heart transplant).…”

Section: Introductionmentioning

confidence: 99%

Does presence of left ventricular contractile reserve improve response to cardiac resynchronization therapy? An updated meta-analysis

Papageorgiou

Providência

Lambiase

et al. 2018

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

Does presence of left ventricular contractile reserve improve response to cardiac resynchronization therapy? An updated meta-analysis

Papageorgiou

Providência

Lambiase

et al. 2018

International Journal of Cardiology

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“…strain, contractile reserve) were not assessed. 22 The relationship of these metrics to cystatin C may warrant future exploration. Finally, the cost-effectiveness of utilizing cystatin C in the identification of high-risk patients will need to be assessed in future analyses pending the availability of point of care testing.…”

Section: Discussionmentioning

confidence: 99%

Incremental value of cystatin C over conventional renal metrics for predicting clinical response and outcomes in cardiac resynchronization therapy: The BIOCRT study

Chatterjee

Singh

Szymonifka

et al. 2016

International Journal of Cardiology

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Background Despite the benefit of CRT in select patients with heart failure (HF), there remains significant need for predicting those at risk for adverse outcomes for this effective but costly therapy. CysC, an emerging marker of renal function, is predictive of worsening symptoms and mortality in patients with HF. This study assessed the utility of baseline and serial measures of cystatin C (CysC), compared to conventional creatinine-based measures of renal function (estimated glomerular filtration rate, eGFR), in predicting clinical outcomes following cardiac resynchronization therapy (CRT). Methods In 133 patients, we measured peripheral venous (PV) and coronary sinus (CS) CysC concentrations and peripheral creatinine levels at the time of CRT implant. Study endpoints included clinical response to CRT at 6 months and major adverse cardiac events (MACE) at 2 years. Results While all 3 renal metrics were predictive of MACE (all adjusted p≤0.02), only CysC was associated with CRT non-response at 6 months (adjusted odds ratio 3.6, p=0.02). CysC improved prediction of CRT non-response (p≤0.003) in net reclassification index analysis compared to models utilizing standard renal metrics. Serial CysC >1mg/L was associated with 6-month CRT non-response and reduced 6-minute walk distance as well as 2-year MACE (all p≤0.04). Conclusion In patients undergoing CRT, CysC demonstrated incremental benefit in the prediction of CRT non-response when compared to standard metrics of renal function. Baseline and serial measures of elevated CysC were predictive of CRT non-response and functional status at 6 months as well as long term clinical outcomes.

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“…Speckle tracking echocardiography has been used in several studies to measure scar area, the area of latest mechanical activation, prognosis of lead placement, survival rate free from defibrillator therapy, and its correlates with CMR . Because the RA is the source of such electrical phenomena, it would be worthwhile to focus on it through STE to elucidate the novel mechanistic insights of electrical activation.…”

Section: Methods To Measure Strainmentioning

confidence: 99%

Speckle Tracking Echocardiography of the Right Atrium: The Neglected Chamber

Sultan

Lima

Munir

et al. 2015

Clinical Cardiology

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The right atrium (RA) plays a pivotal role in electromechanical and endocrine regulation of the heart. Its peculiar anatomical features and phasic mechanical function make it distinct from ventricles. Various invasive and noninvasive techniques have been used to elucidate RA structure and function. Of these modalities, echocardiography has distinct advantages over others. Several conventional measures of RA function through echocardiography have been described in the literature, but they are load dependent. A relatively new technique is speckle tracking-derived strain, which is relatively less dependent on loading conditions. Speckle tracking echocardiography tracks acoustic scatters (speckles) of myocardium frame-by-frame to calculate strain or deformation of the myocardium. Speckle tracking echocardiography has been used extensively for strain assessment of the right and left ventricle to detect subtle disease pathology, to gain mechanistic insight, as a marker of ischemic metabolic memory, as an endpoint in clinical trials, and as a functional assessment tool. The RA is a relatively neglected chamber, as it is mostly studied for assessment of atrial mass lesions, for electrophysiological studies, and in animal models for physiological assessment. However, its role in the systolic and diastolic function of the right heart, pulmonary vascular pathology, congenital heart diseases, and combined electromechanical activation phenomena has been less explored or unexplored. Speckle tracking echocardiography is an ideal tool for the assessment of the RA because of its regional and global functional characterization, angle independence, and high temporal resolution. IntroductionThe right atrium (RA) is located on the anterosuperior aspect of the heart and lies anterior to the left atrium (LA), which forms the most posterior chamber of the heart. The interatrial septum is oblique (at 65 degrees) to the cardiac axis and the tricuspid and mitral valves are located at different levels; therefore, the RA lies anterior and inferior to the LA.

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Regional myocardial contractile reserve assessed by strain echocardiography and the response to cardiac resynchronization therapy

Cited by 6 publications

References 17 publications

Does presence of left ventricular contractile reserve improve response to cardiac resynchronization therapy? An updated meta-analysis

Does presence of left ventricular contractile reserve improve response to cardiac resynchronization therapy? An updated meta-analysis

Incremental value of cystatin C over conventional renal metrics for predicting clinical response and outcomes in cardiac resynchronization therapy: The BIOCRT study

Speckle Tracking Echocardiography of the Right Atrium: The Neglected Chamber

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