Aim: To compare the ability of myocardial velocity and deformation indexes of left ventricular (LV) dyssynchrony to predict success of cardiac resynchronization therapy (CRT) in patients with heart failure (HF). Methods and results: Thirty-seven patients with dilated cardiomyopathy, NYHA class III–IV, LVejection fraction (EF) <35%, QRS >120 ms underwent CRT. The standard deviation of the averaged time-to-peak negative strain (Tε-SD, ms) and time-to-peak positive systolic velocity (Ts-SD) of 12 middle and basal LV segments obtained from the 3 standard apical views were calculated before and after 6 months. Responders were defined at month 6 by ≥20% EF increase and/or ≥15% end-systolic volume (ESV) decrease with respect to baseline. At the univariate analysis, baseline Tε-SD and Ts-SD were both significantly associated with CRT response but at the bivariate analysis only Tε-SD retained an independent prognostic value for CRT response. The strength of association between baseline dyssynchrony and EF and ESV variation was better for Tε-SD (r=0.88 vs. ΔEF; r=−0.78 vs. ΔESV) than for Ts-SD (r=0.62 vs. ΔEF; r=−0.57 vs. ΔESV). Conclusions: Baseline dyssynchrony of longitudinal myocardial peak deformation is better than dyssynchrony of longitudinal myocardial peak systolic velocities for identification of CRT responders.
Myocardial deformation dyssynchrony is better than velocity dyssynchrony to identify responders to CRT
CECONI, Claudio;
2007
Abstract
Aim: To compare the ability of myocardial velocity and deformation indexes of left ventricular (LV) dyssynchrony to predict success of cardiac resynchronization therapy (CRT) in patients with heart failure (HF). Methods and results: Thirty-seven patients with dilated cardiomyopathy, NYHA class III–IV, LVejection fraction (EF) <35%, QRS >120 ms underwent CRT. The standard deviation of the averaged time-to-peak negative strain (Tε-SD, ms) and time-to-peak positive systolic velocity (Ts-SD) of 12 middle and basal LV segments obtained from the 3 standard apical views were calculated before and after 6 months. Responders were defined at month 6 by ≥20% EF increase and/or ≥15% end-systolic volume (ESV) decrease with respect to baseline. At the univariate analysis, baseline Tε-SD and Ts-SD were both significantly associated with CRT response but at the bivariate analysis only Tε-SD retained an independent prognostic value for CRT response. The strength of association between baseline dyssynchrony and EF and ESV variation was better for Tε-SD (r=0.88 vs. ΔEF; r=−0.78 vs. ΔESV) than for Ts-SD (r=0.62 vs. ΔEF; r=−0.57 vs. ΔESV). Conclusions: Baseline dyssynchrony of longitudinal myocardial peak deformation is better than dyssynchrony of longitudinal myocardial peak systolic velocities for identification of CRT responders.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
