BACKGROUND: Mechanical dyssynchrony has proven to be superior to QRS duration in predicting response to cardiac resynchronisation therapy (CRT). Whether time to peak longitudinal strain delay between the mid-septum and mid-lateral left ventricular wall better predicts CRT response than tissue Doppler imaging (TDI) is unclear. This study compares the value of the two methods for the assessment of mechanical dyssynchrony and prediction of CRT responders. METHODS: 66 clinical responders and 17 nonresponders to CRT with severe systolic heart failure (LVEF <35%), New York Heart Association classification III or IV and a wide QRS >130 ms with left bundle branch block were evaluated by peak longitudinal strain and TDI. Doppler echocardiograms and electromechanical time delay (EMD) intervals were acquired before and after pacemaker implantation. RESULTS: In all responders EMD measured by peak longitudinal strain was >60 ms before implantation, compared with 76% of the patients measured by TDI. Nonresponders had EMD <60 ms measured by both techniques. Only peak longitudinal strain delay showed shortened values in every responder postimplantation and demonstrated the most significant reduction and could predict responders to CRT. However, EMD measured by TDI did not diminish in 30% of the positive clinical responders. Nonresponders showed worsening of the EMD with peak longitudinal strain, but not with TDI. CONCLUSIONS: Responders to CRT can be excellently predicted if EMD before implantation determined by peak longitudinal strain delay is >60 ms. Peak longitudinal strain delay appears to be superior to TDI to predict the response to CRT. (Neth Heart J 2010;18:574-82.).
BACKGROUND:Mechanical dyssynchrony has proven to be superior to QRS duration in predicting response to cardiac resynchronisation therapy (CRT). Whether time to peak longitudinal strain delay between the mid-septum and mid-lateral left ventricular wall better predicts CRT response than tissue Doppler imaging (TDI) is unclear. This study compares the value of the two methods for the assessment of mechanical dyssynchrony and prediction of CRT responders. METHODS: 66 clinical responders and 17 nonresponders to CRT with severe systolic heart failure (LVEF <35%), New York Heart Association classification III or IV and a wide QRS >130 ms with left bundle branch block were evaluated by peak longitudinal strain and TDI. Doppler echocardiograms and electromechanical time delay (EMD) intervals were acquired before and after pacemaker implantation. RESULTS: In all responders EMD measured by peak longitudinal strain was >60 ms before implantation, compared with 76% of the patients measured by TDI. Nonresponders had EMD <60 ms measured by both techniques. Only peak longitudinal strain delay showed shortened values in every responder postimplantation and demonstrated the most significant reduction and could predict responders to CRT. However, EMD measured by TDI did not diminish in 30% of the positive clinical responders. Nonresponders showed worsening of the EMD with peak longitudinal strain, but not with TDI. CONCLUSIONS: Responders to CRT can be excellently predicted if EMD before implantation determined by peak longitudinal strain delay is >60 ms. Peak longitudinal strain delay appears to be superior to TDI to predict the response to CRT. (Neth Heart J 2010;18:574-82.).
Authors: Cheuk-Man Yu; Jeffrey Wing-Hong Fung; Qing Zhang; Chi-Kin Chan; Yat-Sun Chan; Hong Lin; Leo C C Kum; Shun-Ling Kong; Yan Zhang; John E Sanderson Journal: Circulation Date: 2004-06-14 Impact factor: 29.690
Authors: Tomasz Kukulski; Fadi Jamal; Jan D'Hooge; Bart Bijnens; Ivan De Scheerder; George R Sutherland Journal: J Am Soc Echocardiogr Date: 2002-01 Impact factor: 5.251
Authors: Peter Sogaard; Henrik Egeblad; Anders K Pedersen; Won Yong Kim; Bent O Kristensen; Peter S Hansen; Peter T Mortensen Journal: Circulation Date: 2002-10-15 Impact factor: 29.690
Authors: Steven L Higgins; John D Hummel; Imran K Niazi; Michael C Giudici; Seth J Worley; Leslie A Saxon; John P Boehmer; Michael B Higginbotham; Teresa De Marco; Elyse Foster; Patrick G Yong Journal: J Am Coll Cardiol Date: 2003-10-15 Impact factor: 24.094
Authors: Zoran B Popović; Richard A Grimm; George Perlic; Edward Chinchoy; Maria Geraci; Jing Ping Sun; Erwan Donal; Xiao-Fang Xu; Neil L Greenberg; Bruce L Wilkoff; James D Thomas Journal: J Cardiovasc Electrophysiol Date: 2002-12
Authors: Ole A Breithardt; Christoph Stellbrink; Lieven Herbots; Piet Claus; Anil M Sinha; Bart Bijnens; Peter Hanrath; George R Sutherland Journal: J Am Coll Cardiol Date: 2003-08-06 Impact factor: 24.094