OBJECTIVES: We sought to evaluate the long-term impact of cardiac resynchronization therapy (CRT) on left ventricular (LV) performance and remodeling using three-dimensional echocardiography and tissue Doppler imaging (TDI). BACKGROUND: Three-dimensional echocardiography and TDI allow rapid and accurate evaluation of LV volumes and performance. METHODS: Twenty-five consecutive patients with severe heart failure and bundle branch block who underwent biventricular pacemaker implantation were included. Before and after implantation of the pacemaker, three-dimensional echocardiography and TDI were performed. These examinations were repeated at outpatient visits every six months. RESULTS: Five patients (20%) died during one-year follow-up. In the remaining 20 patients, significant reductions in LV end-diastolic volume and LV end-systolic volume of 9.6 +/- 14% and 16.5 +/- 15%, respectively (p < 0.01), could be demonstrated during long-term follow-up. Accordingly, LV ejection fraction increased by 21.7 +/- 18% (p < 0.01). According to a newly developed TDI technique-tissue tracking-all regional myocardial segments improved their longitudinal systolic shortening (p < 0.01). The extent of the LV base displaying delayed longitudinal contraction, as detected by TDI before pacemaker implantation, predicted long-term efficacy of CRT. The QRS duration failed to predict resynchronization efficacy. CONCLUSIONS: Cardiac resynchronization significantly improved LV function and reversed LV remodeling during long-term follow-up. Patients likely to benefit from CRT can be identified by TDI before implantation of a biventricular pacemaker.
OBJECTIVES: We sought to evaluate the long-term impact of cardiac resynchronization therapy (CRT) on left ventricular (LV) performance and remodeling using three-dimensional echocardiography and tissue Doppler imaging (TDI). BACKGROUND: Three-dimensional echocardiography and TDI allow rapid and accurate evaluation of LV volumes and performance. METHODS: Twenty-five consecutive patients with severe heart failure and bundle branch block who underwent biventricular pacemaker implantation were included. Before and after implantation of the pacemaker, three-dimensional echocardiography and TDI were performed. These examinations were repeated at outpatient visits every six months. RESULTS: Five patients (20%) died during one-year follow-up. In the remaining 20 patients, significant reductions in LV end-diastolic volume and LV end-systolic volume of 9.6 +/- 14% and 16.5 +/- 15%, respectively (p < 0.01), could be demonstrated during long-term follow-up. Accordingly, LV ejection fraction increased by 21.7 +/- 18% (p < 0.01). According to a newly developed TDI technique-tissue tracking-all regional myocardial segments improved their longitudinal systolic shortening (p < 0.01). The extent of the LV base displaying delayed longitudinal contraction, as detected by TDI before pacemaker implantation, predicted long-term efficacy of CRT. The QRS duration failed to predict resynchronization efficacy. CONCLUSIONS: Cardiac resynchronization significantly improved LV function and reversed LV remodeling during long-term follow-up. Patients likely to benefit from CRT can be identified by TDI before implantation of a biventricular pacemaker.
Authors: Andrew D Feingold; Dennis A Tighe; Gerard P Aurigemma; Jeffrey C Hill; Craig S Vinch Journal: Curr Cardiol Rep Date: 2004-05 Impact factor: 2.931
Authors: Sebastian J Buss; Felix Schulz; David Wolf; Waldemar Hosch; Christian Galuschky; Georg Schummers; Evangelos Giannitsis; Hans-Ulrich Kauczor; Christian Zugck; Ruediger Becker; Stefan E Hardt; Hugo A Katus; Grigorios Korosoglou Journal: Eur Radiol Date: 2012-01-22 Impact factor: 5.315