OBJECTIVES: We sought to determine the feasibility of cardiac computed tomography (CT) to detect significant differences in the extent of left ventricular dyssynchrony in heart failure (HF) patients with wide QRS, HF patients with narrow QRS, and age-matched controls. BACKGROUND: The degree of mechanical dyssynchrony has been suggested as a predictor of response to cardiac resynchronization therapy. There have been no published reports of dyssynchrony assessment with the use of CT. METHODS: Thirty-eight subjects underwent electrocardiogram-gated contrast-enhanced 64-slice multidetector CT. The left ventricular endocardial and epicardial boundaries were delineated from short-axis images reconstructed at 10% phase increments of the cardiac cycle. Global and segmental CT dyssynchrony metrics that used changes in wall thickness, wall motion, and volume over time were assessed for reproducibility. We defined a global metric using changes in wall thickness as the dyssynchrony index (DI). RESULTS: The DI was the most reproducible metric (interobserver and intraobserver intraclass correlation coefficients >/=0.94, p < 0.0001) and was used to determine differences between the 3 groups: HF-wide QRS group (ejection fraction [EF] 22 +/- 8%, QRS 163 +/- 28 ms), HF-narrow QRS (EF 26 +/- 7%, QRS 96 +/- 11 ms), and age-matched control subjects (EF 64 +/- 5%, QRS 87 +/- 9 ms). Mean DI was significantly different between the 3 groups (HF-wide QRS: 152 +/- 44 ms, HF-narrow QRS: 121 +/- 58 ms, and control subjects: 65 +/- 12 ms; p < 0.0001) and greater in the HF-wide QRS (p < 0.0001) and HF-narrow QRS (p = 0.005) groups compared with control subjects. We found that DI had a good correlation with 2-dimensional (r = 0.65, p = 0.012) and 3-dimensional (r = 0.68, p = 0.008) echocardiographic dyssynchrony. CONCLUSIONS: Quantitative assessment of global CT-derived DI, based on changes in wall thickness over time, is highly reproducible and renders significant differences between subjects most likely to have dyssynchrony and age-matched control subjects.
OBJECTIVES: We sought to determine the feasibility of cardiac computed tomography (CT) to detect significant differences in the extent of left ventricular dyssynchrony in heart failure (HF) patients with wide QRS, HF patients with narrow QRS, and age-matched controls. BACKGROUND: The degree of mechanical dyssynchrony has been suggested as a predictor of response to cardiac resynchronization therapy. There have been no published reports of dyssynchrony assessment with the use of CT. METHODS: Thirty-eight subjects underwent electrocardiogram-gated contrast-enhanced 64-slice multidetector CT. The left ventricular endocardial and epicardial boundaries were delineated from short-axis images reconstructed at 10% phase increments of the cardiac cycle. Global and segmental CT dyssynchrony metrics that used changes in wall thickness, wall motion, and volume over time were assessed for reproducibility. We defined a global metric using changes in wall thickness as the dyssynchrony index (DI). RESULTS: The DI was the most reproducible metric (interobserver and intraobserver intraclass correlation coefficients >/=0.94, p < 0.0001) and was used to determine differences between the 3 groups: HF-wide QRS group (ejection fraction [EF] 22 +/- 8%, QRS 163 +/- 28 ms), HF-narrow QRS (EF 26 +/- 7%, QRS 96 +/- 11 ms), and age-matched control subjects (EF 64 +/- 5%, QRS 87 +/- 9 ms). Mean DI was significantly different between the 3 groups (HF-wide QRS: 152 +/- 44 ms, HF-narrow QRS: 121 +/- 58 ms, and control subjects: 65 +/- 12 ms; p < 0.0001) and greater in the HF-wide QRS (p < 0.0001) and HF-narrow QRS (p = 0.005) groups compared with control subjects. We found that DI had a good correlation with 2-dimensional (r = 0.65, p = 0.012) and 3-dimensional (r = 0.68, p = 0.008) echocardiographic dyssynchrony. CONCLUSIONS: Quantitative assessment of global CT-derived DI, based on changes in wall thickness over time, is highly reproducible and renders significant differences between subjects most likely to have dyssynchrony and age-matched control subjects.
Authors: Jeroen J Bax; Theodore Abraham; S Serge Barold; Ole A Breithardt; Jeffrey W H Fung; Stephane Garrigue; John Gorcsan; David L Hayes; David A Kass; Juhani Knuuti; Christophe Leclercq; Cecilia Linde; Daniel B Mark; Mark J Monaghan; Petros Nihoyannopoulos; Martin J Schalij; Christophe Stellbrink; Cheuk-Man Yu Journal: J Am Coll Cardiol Date: 2005-12-20 Impact factor: 24.094
Authors: Jeroen J Bax; Theodore Abraham; S Serge Barold; Ole A Breithardt; Jeffrey W H Fung; Stephane Garrigue; John Gorcsan; David L Hayes; David A Kass; Juhani Knuuti; Christophe Leclercq; Cecilia Linde; Daniel B Mark; Mark J Monaghan; Petros Nihoyannopoulos; Martin J Schalij; Christophe Stellbrink; Cheuk-Man Yu Journal: J Am Coll Cardiol Date: 2005-12-20 Impact factor: 24.094
Authors: Zayd A Eldadah; Boaz Rosen; Ilan Hay; Thor Edvardsen; Vinod Jayam; Timm Dickfeld; Glenn R Meininger; Daniel P Judge; Joshua Hare; Joao B Lima; Hugh Calkins; Ronald D Berger Journal: Heart Rhythm Date: 2006-04 Impact factor: 6.343
Authors: Thomas G Flohr; Cynthia H McCollough; Herbert Bruder; Martin Petersilka; Klaus Gruber; Christoph Süss; Michael Grasruck; Karl Stierstorfer; Bernhard Krauss; Rainer Raupach; Andrew N Primak; Axel Küttner; Stefan Achenbach; Christoph Becker; Andreas Kopp; Bernd M Ohnesorge Journal: Eur Radiol Date: 2005-12-10 Impact factor: 5.315
Authors: Wayne Rosamond; Katherine Flegal; Gary Friday; Karen Furie; Alan Go; Kurt Greenlund; Nancy Haase; Michael Ho; Virginia Howard; Brett Kissela; Bret Kissela; Steven Kittner; Donald Lloyd-Jones; Mary McDermott; James Meigs; Claudia Moy; Graham Nichol; Christopher J O'Donnell; Veronique Roger; John Rumsfeld; Paul Sorlie; Julia Steinberger; Thomas Thom; Sylvia Wasserthiel-Smoller; Yuling Hong Journal: Circulation Date: 2006-12-28 Impact factor: 29.690
Authors: Jos J M Westenberg; Hildo J Lamb; Rob J van der Geest; Gabe B Bleeker; Eduard R Holman; Martin J Schalij; Albert de Roos; Ernst E van der Wall; Johan H C Reiber; Jeroen J Bax Journal: J Am Coll Cardiol Date: 2006-04-24 Impact factor: 24.094
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
Authors: Wael AlJaroudi; Ji Chen; Wael A Jaber; Steven G Lloyd; Manuel D Cerqueira; Thomas Marwick Journal: Circ Cardiovasc Imaging Date: 2011-05 Impact factor: 7.792
Authors: Zoubin Alikhani; Jonathan Li; Juan A Merchan; Niels Nijhof; Jeffrey Mendel; Michael V Orlov Journal: J Interv Card Electrophysiol Date: 2012-11-30 Impact factor: 1.900
Authors: Quynh A Truong; Jackie Szymonifka; Michael H Picard; Wai-Ee Thai; Bryan Wai; Jim W Cheung; E Kevin Heist; Udo Hoffmann; Jagmeet P Singh Journal: Heart Rhythm Date: 2018-03-20 Impact factor: 6.343