The Association of a classical left bundle Branch Block Contraction Pattern by vendor-independent strain echocardiography and outcome after cardiac resynchronization therapy

Autor: Kasper Emerek, Daniel J. Friedman, Peter L. Sørensen, Steen M. Hansen, Jacob M. Larsen, Niels Risum, Anna Margrethe Thøgersen, Claus Graff, Brett D. Atwater, Joseph Kisslo, Peter Søgaard
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Cardiovascular Ultrasound, Vol 17, Iss 1, Pp 1-9 (2019)
Druh dokumentu: article
ISSN: 1476-7120
DOI: 10.1186/s12947-019-0160-4
Popis: Abstract Background The association of a Classical left bundle branch block (LBBB) contraction pattern and better outcome after cardiac resynchronization therapy (CRT) has only been studied using vendor-specific software for echocardiographic speckle-tracked longitudinal strain analysis. The purpose of this study was to assess whether a Classical LBBB contraction pattern on longitudinal strain analysis using vendor-independent software is associated with clinical outcome in CRT recipients with LBBB. Methods This was a retrospective cohort study including CRT recipients with LBBB, heart failure, and left ventricular (LV) ejection fraction ≤35%. Speckle-tracked echocardiographic longitudinal strain analysis was performed retrospectively on echocardiograms using vendor-independent software. The presence of a Classical LBBB contraction pattern was determined by consensus of two readers. The primary end point was a composite of time to death, heart transplantation or LV assist device implantation. Secondary outcome was ≥15% reduction in LV end-systolic volume. Intra- and inter-reader agreement of the longitudinal strain contraction pattern was assessed by calculating Cohen’s κ. Results Of 283 included patients, 113 (40%) were women, mean age was 66 ± 11 years, and 136 (48%) had ischemic heart disease. A Classical LBBB contraction pattern was present in 196 (69%). The unadjusted hazard ratio for reaching the primary end point was 1.93 (95% confidence interval, 1.36–2.76, p
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