Document Detail


A radial global dyssynchrony index as predictor of left ventricular reverse remodeling after cardiac resynchronization therapy.
MedLine Citation:
PMID:  18684278     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac mechanical efficiency requires that opposing left ventricular regions are coupled both in shortening and lengthening during the same phase of cardiac cycle. Aim of this study was to evaluate whether global measures of mechanical dyssynchrony are able to predict reverse remodeling of the left ventricle in patients receiving cardiac resynchronization therapy (CRT). METHODS: Sixty-two patients underwent a clinical examination, including New York Heart Association class evaluation and 6-minute walking distance and both echocardiographic study before and 6 months after CRT. Intraventricular dyssynchrony was evaluated by two-dimensional strain echocardiography, measuring the amount of uncoordinated contraction and relaxation between septum and free wall for both longitudinal and radial function and was presented as the longitudinal global dyssynchrony index (LGDI) and the radial global dyssynchrony index (RGDI). Reverse remodeling was defined by a left ventricular end systolic volume reduction >or= 15%. RESULTS: After CRT 39 patients showed reverse remodeling. In this group, RGDI (0.74 +/- 0.26 vs 0.32 +/- 0.30; P = 0.0001) and LGDI (0.52 +/- 0.28 vs 0.30 +/- 0.24; P = 0.002) were significantly higher than in nonresponders. A receiver-operating characteristic curve analysis showed that RGDI >0.47 and LGDI >0.34 had a sensitivity and a specificity to predict reverse remodeling of 87% and 74%, 82%, and 74%, respectively. Stepwise forward multiple logistic regression analysis showed that RGDI (O.R.:13.4; 95%C.I.:4.2-120.5; P < 0.0001) was an independent determinant of a positive response to CRT. CONCLUSION: A radial global dyssynchrony index predicts left ventricular reverse remodeling after CRT.
Authors:
Luigi Ascione; Raffaele Iengo; Maria Accadia; Salvatore Rumolo; Eduardo Celentano; Antonello D'Andrea; Mario De Michele; Carmine Muto; Giovanni Carreras; Marco Maglione; Bernardino Tuccillo; Jos Roelandt
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  31     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-08-07     Completed Date:  2008-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  819-27     Citation Subset:  IM    
Affiliation:
Division of Cardiology, S. Maria di Loreto Hospital, Naples, Italy. luigi.ascione20@tin.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Elasticity Imaging Techniques / methods*
Female
Heart Failure / diagnosis*,  prevention & control*
Humans
Image Interpretation, Computer-Assisted / methods*
Male
Outcome Assessment (Health Care) / methods*
Prognosis
Treatment Outcome
Ventricular Dysfunction, Left / diagnosis*,  prevention & control*
Ventricular Remodeling

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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