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Article: Effect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imaging

TitleEffect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imaging
Authors
KeywordsAged
Echocardiography/*methods
Female
Follow-Up Studies
Heart Failure/physiopathology/*therapy/ultrasonography
Heart Ventricles/physiopathology/*ultrasonography
Humans
Male
Myocardial Revascularization/*methods
Stroke Volume
Treatment Outcome
Ventricular Function, Left/*physiology
*Ventricular Remodeling
Issue Date2014
Citation
The American Journal of Cardiology, 2014, v. 113 n. 6, p. 982-987 How to Cite?
AbstractCardiac resynchronization therapy (CRT) induces left ventricular (LV) reverse remodeling by synchronizing LV mechanical activation. We evaluated changes in segmental LV activation after CRT and related them to CRT response. A total of 292 patients with heart failure (65 +/- 10 years, 77% men) treated with CRT underwent baseline echocardiographic assessment of LV volumes and ejection fraction. Time-to-peak radial strain was measured for 6 midventricular LV segments with speckle-tracking strain imaging. Moreover, the time difference between the peak radial strain of the anteroseptal and the posterior segments was calculated to obtain LV dyssynchrony. After 6 months, LV volumes, segmental LV mechanical activation timings, and LV dyssynchrony were reassessed. Response to CRT was defined as >/=15% decrease in LV end-systolic volume at 6-month follow-up. Responders (n = 177) showed LV resynchronization 6 months after CRT (LV dyssynchrony from 200 +/- 127 to 85 +/- 86 ms; p <0.001) by earlier activation of the posterior segment (from 438 +/- 141 to 394 +/- 132 ms; p = 0.001) and delayed activation of the anteroseptal segment (from 295 +/- 155 to 407 +/- 138 ms; p <0.001). In contrast, nonresponders (n = 115) experienced an increase in LV dyssynchrony 6 months after CRT (from 106 +/- 86 to 155 +/- 112 ms; p = 0.001) with an earlier activation of posterior wall (from 391 +/- 139 to 355 +/- 136 ms; p = 0.039) that did not match the delayed anteroseptal activation (from 360 +/- 148 to 415 +/- 122 ms; p = 0.001). In conclusion, responders to CRT showed LV resynchronization through balanced lateral and anteroseptal activations. In nonresponders, LV dyssynchrony remains, by posterior wall preactivation and noncompensatory delayed septal wall activation.
Persistent Identifierhttp://hdl.handle.net/10722/207690
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAuger, Den_US
dc.contributor.authorHoke, Uen_US
dc.contributor.authorThijssen, Jen_US
dc.contributor.authorAbate, Een_US
dc.contributor.authorYiu, KHen_US
dc.contributor.authorEwe, SHen_US
dc.contributor.authorWitkowski, TGen_US
dc.contributor.authorLeong, DPen_US
dc.contributor.authorHolman, ERen_US
dc.contributor.authorAjmone Marsan, Nen_US
dc.contributor.authorSchalij, MJen_US
dc.contributor.authorBax, JJen_US
dc.contributor.authorDelgado, Ven_US
dc.date.accessioned2015-01-19T04:20:04Z-
dc.date.available2015-01-19T04:20:04Z-
dc.date.issued2014en_US
dc.identifier.citationThe American Journal of Cardiology, 2014, v. 113 n. 6, p. 982-987en_US
dc.identifier.issn0002-9149en_US
dc.identifier.urihttp://hdl.handle.net/10722/207690-
dc.description.abstractCardiac resynchronization therapy (CRT) induces left ventricular (LV) reverse remodeling by synchronizing LV mechanical activation. We evaluated changes in segmental LV activation after CRT and related them to CRT response. A total of 292 patients with heart failure (65 +/- 10 years, 77% men) treated with CRT underwent baseline echocardiographic assessment of LV volumes and ejection fraction. Time-to-peak radial strain was measured for 6 midventricular LV segments with speckle-tracking strain imaging. Moreover, the time difference between the peak radial strain of the anteroseptal and the posterior segments was calculated to obtain LV dyssynchrony. After 6 months, LV volumes, segmental LV mechanical activation timings, and LV dyssynchrony were reassessed. Response to CRT was defined as >/=15% decrease in LV end-systolic volume at 6-month follow-up. Responders (n = 177) showed LV resynchronization 6 months after CRT (LV dyssynchrony from 200 +/- 127 to 85 +/- 86 ms; p <0.001) by earlier activation of the posterior segment (from 438 +/- 141 to 394 +/- 132 ms; p = 0.001) and delayed activation of the anteroseptal segment (from 295 +/- 155 to 407 +/- 138 ms; p <0.001). In contrast, nonresponders (n = 115) experienced an increase in LV dyssynchrony 6 months after CRT (from 106 +/- 86 to 155 +/- 112 ms; p = 0.001) with an earlier activation of posterior wall (from 391 +/- 139 to 355 +/- 136 ms; p = 0.039) that did not match the delayed anteroseptal activation (from 360 +/- 148 to 415 +/- 122 ms; p = 0.001). In conclusion, responders to CRT showed LV resynchronization through balanced lateral and anteroseptal activations. In nonresponders, LV dyssynchrony remains, by posterior wall preactivation and noncompensatory delayed septal wall activation.en_US
dc.languageengen_US
dc.relation.ispartofThe American Journal of Cardiologyen_US
dc.subjectAgeden_US
dc.subjectEchocardiography/*methodsen_US
dc.subjectFemaleen_US
dc.subjectFollow-Up Studiesen_US
dc.subjectHeart Failure/physiopathology/*therapy/ultrasonographyen_US
dc.subjectHeart Ventricles/physiopathology/*ultrasonographyen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMyocardial Revascularization/*methodsen_US
dc.subjectStroke Volumeen_US
dc.subjectTreatment Outcomeen_US
dc.subjectVentricular Function, Left/*physiologyen_US
dc.subject*Ventricular Remodelingen_US
dc.titleEffect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imagingen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH: khkyiu@hku.hken_US
dc.identifier.authorityYiu, KH=rp01490en_US
dc.identifier.doi10.1016/j.amjcard.2013.11.059en_US
dc.identifier.pmid24462070-
dc.identifier.scopuseid_2-s2.0-84896694427-
dc.identifier.hkuros254843-
dc.identifier.volume113en_US
dc.identifier.issue6en_US
dc.identifier.spage982en_US
dc.identifier.epage987en_US
dc.identifier.isiWOS:000333476700013-

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