Correlation between Myocardial Velocity Measured using Tissue Doppler Imaging in the Left Ventricular Lead-Implanted Segment and Response to Cardiac Resynchronization Therapy

Abstract

OBJECTIVES:This study investigated whether tissue Doppler imaging parameters, especially the peak systolic velocity of the left ventricular lead-implanted segment (Ss), affect cardiac resynchronization therapy response.METHODS:In this case-control study, 110 enrolled patients were divided into cases (responder group, n=65) and controls (nonresponder group, n=45) based on whether their left ventricular end-systolic volume was reduced by ≥15% at 6 months after surgery. Preoperative clinical and echocardiographic data were collected. Multivariate logistic regression models were used to analyze the factors affecting the response to cardiac resynchronization therapy, and receiver operating characteristic curves were plotted to evaluate their diagnostic values.RESULTS:The proportion of patients with left bundle branch block in the case group was higher than that in the control group. The control group showed a higher left atrial volume index, E/A ratio and E/Em ratio but lower Ss than that of the case group. A multivariate regression analysis showed that left bundle branch block, Ss, and an E/Em ratio>14 were independent risk factors affecting the response to cardiac resynchronization therapy. Ss=4.1 cm/s was the best diagnostic threshold according to the receiver operating characteristic curve.CONCLUSIONS:Ss is an important factor affecting the response to cardiac resynchronization therapy. Patients with heart failure associated with Ss<4.1 cm/s have a higher risk of nonresponse.

A novel index combining diastolic and systolic tissue Doppler parameters for predicting cardiac resynchronization therapy response

“…Patients must have basal myocardial viability to respond to this treatment. As Yang et al 19 showed, patients…”

“…Our study group includes left ventricular dyssynchrony patients, which may explain the differences. Yang et al19 showed that the Sa velocity at the left ventricular electrode implantation site was a significant predictor of CRT response. The response of the left ventricular lateral region to resynchronization therapy can be regarded as the main TA B L E 3 Echocardiographic index of baseline and sixth month…”

Tissue Doppler echocardiography and outcome in arrhythmogenic right ventricular cardiomyopathy

“…Previous studies demonstrated that TDI values are significantly higher in control subjects as compared to ARVC patients [16,19]. Other studies demonstrated that TDI-derived parameters can predict major adverse cardiovascular events in normal and heart failure populations [11,[20][21][22]. However, it is not known whether TDI-derived parameters are useful for predicting adverse outcome in patients with ARVC.…”