Role of echocardiographic dyssynchrony parameters in predicting response to cardiac resynchronization therapy
| Autor: | Luca Bergamasco, Stefano Maffè, Daniela Kozel, Lorenzo Cucchi, Franco Zenone, Umberto Parravicini, Pierfranco Dellavesa, Fabiana Signorotti, Anna Maria Paino, Lara Baduena, Nicolò Franchetti Pardo, Paola Paffoni, Antonello Perucca |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Cardiac resynchronization therapy Echocardiography Three-Dimensional Interventricular dyssynchrony Cardiac Resynchronization Therapy Ventricular Dysfunction Left Predictive Value of Tests Internal medicine Image Interpretation Computer-Assisted medicine Humans cardiovascular diseases education Aged Aged 80 and over Heart Failure education.field_of_study business.industry Reproducibility of Results General Medicine Middle Aged medicine.disease Prognosis Echocardiography Doppler Treatment Outcome Heart failure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology Follow-Up Studies |
| Zdroj: | Journal of cardiovascular medicine (Hagerstown, Md.). 16(11) |
| ISSN: | 1558-2035 |
| Popis: | In the present study, we compare different echocardiographic cardiac dyssynchrony parameters, both of intraventricular and interventricular dyssynchrony, in order to predict response to cardiac resynchronization therapy (CRT).In a population of 77 heart failure patients scheduled for CRT, we measured the interventricular mechanical delay (IVMD) and we analyzed six different parameters of intraventricular dyssynchony: the tissue Doppler imaging (TDI) septum-lateral wall delay, the systolic dyssynchrony index; the three-dimensional SD of the time to reach minimum systolic volume for 16 left ventricular segments (3D-SDI); the speckle-tracking radial, circumferential and longitudinal dyssynchrony. At 6 months of follow-up, 61 (79%) patients were responders (≤15% in left ventricular end-systolic volume). On baseline analysis, 3D-SDI, radial strain, longitudinal strain and circumferential strain and IVMD were significantly higher in responder group (10.8 ± 3.9 vs. 7.6 ± 1.8% for 3D-SDI; P = 0.003; 212 ± 91 vs. 125 ± 36 ms for radial strain, P = 0.0003; 185 ± 83 vs. 134 ± 53 ms for longitudinal strain, P = 0.02; 190 ± 80 vs. 130 ± 54 ms for circumferential strain, P = 0.006; 45 ± 21 vs. 30 ± 20 ms for IVMD; P = 0.01). On univariate and multivariate analysis, only IVMD was significantly associated with a complete echocardiographic response to CRT. 3D-SDI and radial strain present the better values of sensitivity and specificity, overall if associated to an evaluation of IVMD (sensitivity 76%, specificity 88%, for 3D-SDI + IVMD; sensitivity 80% and specificity 85% for radial strain + IVMD).The novel parameters, such as 3D-SDI and speckle-tracking (particularly radial strain), offer better diagnostic accuracy in identifying patients who are responders to CRT. The addition of the contemporary parameter of IVMD improves the diagnostic accuracy. |
| Databáze: | OpenAIRE |
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