Document Detail


Tissue synchronisation imaging accurately measures left ventricular dyssynchrony and predicts response to cardiac resynchronisation therapy.
MedLine Citation:
PMID:  17309912     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tissue synchronisation imaging (TSI) is a new technique to assess left ventricular (LV) dyssynchrony.
OBJECTIVES: The value of using TSI to automatically assess LV dyssynchrony compared with manual assessment of LV dyssynchrony from colour-coded tissue Doppler imaging (TDI), and to evaluate the value of TSI to predict response to cardiac resynchronisation therapy (CRT).
METHODS: 60 symptomatic patients with heart failure with depressed LV ejection fraction (LVEF) and QRS >120 ms were evaluated clinically and echocardiographically at baseline and after 6 months of CRT. LV dyssynchrony was measured manually using velocity tracings from the colour-coded TDI and automatically using TSI. LV volumes and LVEF were assessed from two-dimensional echocardiography. Clinical responders had to exhibit an improvement in New York Heart Association functional class by > or =1 score and an improvement by > or =25% in 6 min walking distance after 6 months. Reverse LV remodelling was defined as a reduction of > or =15% LV end-systolic volume.
RESULTS: An excellent correlation was observed between LV dyssynchrony measured manually and automatically derived by TSI (r = 0.95, p<0.001). 34 patients showed clinical response after 6 months of CRT and 32 patients showed reverse remodelling. Baseline characteristics were comparable between responders and non-responders, except for more extensive LV dyssynchrony in the responders: 78 (26) vs 29 (29) ms (p<0.001) as assessed manually, and 79 (29) vs 28 (27) ms (p<0.001) as assessed with TSI. Using a cut-off value of 65 ms to define extensive LV dyssynchrony, TSI had a sensitivity of 81% with a specificity of 89% to predict reverse LV remodelling.
CONCLUSION: TSI allows automatic and reliable assessment of LV dyssynchrony and predicts reverse LV remodelling after CRT.
Authors:
Nico R Van de Veire; Gabe B Bleeker; Johan De Sutter; Claudia Ypenburg; Eduard R Holman; Ernst E van der Wall; Ernst E van der Wal; Martin J Schalij; Jeroen J Bax
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-02-19
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  93     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-10-04     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1034-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. nico.vandeveire@ugent.be
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial*
Echocardiography, Doppler, Color
Female
Follow-Up Studies
Heart Failure / complications,  physiopathology,  therapy*,  ultrasonography*
Humans
Image Processing, Computer-Assisted / methods
Male
Middle Aged
Stroke Volume
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  physiopathology,  therapy*,  ultrasonography*
Ventricular Remodeling
Comments/Corrections
Comment In:
Heart. 2007 Sep;93(9):1017-9   [PMID:  17699167 ]
Erratum In:
Heart. 2008 Dec;94(12):1655.
Note: van der Wal, Ernst E [corrected to van der Wall, Ernst E]

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