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Comparison of myocardial deformation and velocity dyssynchrony for identification of responders to cardiac resynchronization therapy
Author(s) -
Mele Donato,
Toselli Tiziano,
Capasso Fabio,
Stabile Giuseppe,
Piacenti Marcello,
Piepoli Massimo,
Giatti Sara,
Klersy Catherine,
Sallusti Luciano,
Ferrari Roberto
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp032
Subject(s) - medicine , cardiac resynchronization therapy , cardiology , heart failure , deformation (meteorology) , ejection fraction , composite material , materials science
Aims It is unclear whether myocardial velocity or deformation indices of dyssynchrony are better at predicting response to cardiac resynchronization therapy (CRT). Therefore, two indices of left ventricular (LV) dyssynchrony based on myocardial velocity and deformation were compared to predict success of CRT. Methods and results Sixty patients with dilated cardiomyopathy, New York Heart Association class III–IV, LV ejection fraction (EF) ≤35%, QRS >120 ms underwent CRT. The standard deviation of the averaged time‐to‐peak longitudinal negative strain (Tɛ‐SD) and positive systolic velocity (Tv‐SD) of 12 LV segments were calculated before and after 6 months of CRT. Responders were defined at month 6 by ≥20% EF increase and/or ≥15% end‐systolic volume (ESV) decrease with respect to baseline. On univariable analysis, baseline Tɛ‐SD and Tv‐SD were both significantly associated with CRT response; however, the area under the receiver operating characteristic curve was better for Tɛ‐SD. On bivariable analysis, only Tɛ‐SD retained an independent prognostic value for CRT response. Results of the analysis did not change when the logistic models were adjusted for aetiology. Conclusion Baseline dyssynchrony of longitudinal myocardial peak deformation (Tɛ‐SD) appears to be better than dyssynchrony of longitudinal myocardial peak systolic velocities (Tv‐SD) for the identification of CRT responders.