Open AccessStrain imaging to predict response to cardiac resynchronization therapy: a systematic comparison of strain parameters using multiple imaging techniques
Author(s) -
Zweerink Alwin,
Everdingen Wouter M.,
Nijveldt Robin,
Salden Odette A.E.,
Meine Mathias,
Maass Alexander H.,
Vernooy Kevin,
Lange Frederik J.,
Vos Marc A.,
Croisille Pierre,
Clarysse Patrick,
Geelhoed Bastiaan,
Rienstra Michiel,
Gelder Isabelle C.,
Rossum Albert C.,
Cramer Maarten J.,
Allaart Cornelis P.
Publication year - 2018
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12335
Subject(s) - cardiac resynchronization therapy , medicine , cardiology , feature tracking , qrs complex , heart failure , speckle tracking echocardiography , cardiac magnetic resonance , ventricular dyssynchrony , cardiac magnetic resonance imaging , magnetic resonance imaging , strain (injury) , nuclear medicine , ejection fraction , radiology , artificial intelligence , feature extraction , computer science
Aims Various strain parameters and multiple imaging techniques are presently available including cardiovascular magnetic resonance (CMR) tagging (CMR‐TAG), CMR feature tracking (CMR‐FT), and speckle tracking echocardiography (STE). This study aims to compare predictive performance of different strain parameters and evaluate results per imaging technique to predict cardiac resynchronization therapy (CRT) response. Methods and results Twenty‐seven patients were prospectively enrolled and underwent CMR and echocardiographic examination before CRT implantation. Strain analysis was performed in circumferential (CMR‐TAG, CMR‐FT, and STE‐circ) and longitudinal (STE‐long) orientations. Regional strain values, parameters of dyssynchrony, and discoordination were calculated. After 12 months, CRT response was measured by the echocardiographic change in left ventricular (LV) end‐systolic volume (LVESV). Twenty‐six patients completed follow‐up; mean LVESV change was −29 ± 27% with 17 (65%) patients showing ≥15% LVESV reduction. Measures of dyssynchrony (SD‐TTP LV ) and discoordination (ISF LV ) were strongly related to CRT response when using CMR‐TAG ( R 2 0.61 and R 2 0.57, respectively), but showed poor correlations for CMR‐FT and STE (all R 2 ≤ 0.32). In contrast, the end‐systolic septal strain (ESS sep ) parameter showed a consistent high correlation with LVESV change for all techniques (CMR‐TAG R 2 0.60; CMR‐FT R 2 0.50; STE‐circ R 2 0.43; and STE‐long R 2 0.43). After adjustment for QRS duration and QRS morphology, ESS sep remained an independent predictor of response per technique. Conclusions End‐systolic septal strain was the only parameter with a consistent good relation to reverse remodelling after CRT, irrespective of assessment technique. In clinical practice, this measure can be obtained by any available strain imaging technique and provides predictive value on top of current guideline criteria.