| Combined longitudinal and radial dyssynchrony predicts ventricular response after resynchronization therapy. | |
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MedLine Citation:
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PMID: 17919568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to test the hypothesis that a combined echocardiographic assessment of longitudinal dyssynchrony by tissue Doppler imaging (TDI) and radial dyssynchrony by speckle-tracking strain may predict left ventricular (LV) functional response to cardiac resynchronization therapy (CRT). BACKGROUND: Mechanical LV dyssynchrony is associated with response to CRT; however, complex patterns may exist. METHODS: We studied 190 heart failure patients (ejection fraction [EF] 23 +/- 6%, QRS duration 168 +/- 27 ms) before and after CRT. Longitudinal dyssynchrony was assessed by color TDI for time to peak velocity (2 sites in all and 12 sites in a subgroup of 67). Radial dyssynchrony was assessed by speckle-tracking radial strain. The LV response was defined as > or =15% increase in EF. RESULTS: One hundred seventy-six patients (93%) had technically sufficient baseline and follow-up data available. Overall, 34% were EF nonresponders at 6 +/- 3 months after CRT. When both longitudinal dyssynchrony by 2-site TDI (> or =60 ms) and radial dyssynchrony (> or =130 ms) were positive, 95% of patients had an EF response; when both were negative, 21% had an EF response (p < 0.001 vs. both positive). The EF response rate was lowest (10%) when dyssynchrony was negative using 12-site TDI and radial strain (p < 0.001 vs. both positive). When either longitudinal or radial dyssynchrony was positive (but not both), 59% had an EF response. Combined longitudinal and radial dyssynchrony predicted EF response with 88% sensitivity and 80% specificity, which was significantly better than either technique alone (p < 0.0001). CONCLUSIONS: Combined patterns of longitudinal and radial dyssynchrony can be predictive of LV functional response after CRT. |
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Authors:
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John Gorcsan; Masaki Tanabe; Gabe B Bleeker; Matthew S Suffoletto; Nini C Thomas; Samir Saba; Laurens F Tops; Martin J Schalij; Jeroen J Bax |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2007-09-24 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 50 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-10-08 Completed Date: 2007-10-26 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1476-83 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15213-2582, USA. gorcsanj@upmc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Pacing, Artificial* Echocardiography, Doppler / methods* Electrophysiologic Techniques, Cardiac Female Heart Failure / physiopathology*, therapy* Humans Male Middle Aged Prospective Studies ROC Curve Recovery of Function Sensitivity and Specificity Stroke Volume Treatment Outcome Ventricular Function, Left* Ventricular Remodeling |
| Grant Support | |
ID/Acronym/Agency:
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K24 HL04503-01/HL/NHLBI NIH HHS; R01 HL073198-01/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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