Current Role of Echocardiography in Cardiac Resynchronization Therapy: from Cardiac Mechanics to Flow Dynamics Analysis

Mele, Donato; Trevisan, Filippo; Fiorencis, Andrea; Smarrazzo, Vittorio; Bertini, Matteo; Ferrari, Roberto

doi:10.1007/s11897-020-00484-w

Cited by 13 publications

(13 citation statements)

References 51 publications

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“…A number of clinical researches have been performed within the last two years, since this technique was commercially available. To date, MW has been investigated with regard to cardiac resynchronization therapy (CRT) [ 18 – 23 ], in the diagnosis of different categories of coronary heart disease [ 6 , 24 – 28 ] and in the evaluation of cardiomyopathy [ 29 – 33 ]. In addition, MW can also be used to predict and evaluate therapeutic effects [ 34 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

Afterload-related reference values for myocardial work indices

Wang

Feng

et al. 2021

Cardiovasc Ultrasound

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Background The novel noninvasive pressure-strain loop (PSL) is a reliable tool that reflects myocardial work (MW). Systolic blood pressure (SBP) is the only independent factor for MW indices. However, afterload-related reference values have not been previously reported. The aim of the present study was to establish reference values for MW parameters by wide range SBP grading. Methods We prospectively selected healthy individuals and subjects with SBP ≥ 140 mmHg at the time of study without myocardial remodeling. MW parameters were collected and the reference values achieved were grouped by SBP in 10-mmHg. Results Significant differences were noted among the SBP-groups for global work index (GWI) and global constructive work (GCW). The majority of statistical comparisons of the differences in GWI and GCW were significant at each SBP-group. With SBP ranging from 90 to 189 mmHg, the parameters GWI and GCW tended to increase linearly with afterload. Overall, the global wasted work (GWW) tended to rise as SBP was increased, but not all of the differences noted in GWW were significant for each SBP-group. Global work efficiency (GWE) remained stable across all SBP-groups, with the exception of a slight drop noted when it exceeded 160 mmHg. Conclusions The amount of MW but not the work efficiency varied greatly according to the different afterload. This finding cannot be ignored during clinical research or diagnosis and afterload-related reference values are required to make a reasonable judgment on the myocardial function.

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Section: Discussionmentioning

confidence: 99%

Afterload-related reference values for myocardial work indices

Wang

Feng

et al. 2021

Cardiovasc Ultrasound

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“…A number of clinical researches have been performed within the last two years, since this technique was commercially available. To date, MW has been investigated with regard to cardiac resynchronization therapy (CRT) [18][19][20][21][22][23], in the diagnosis of different categories of coronary heart disease [6,[24][25][26][27][28] and in the evaluation of cardiomyopathy [29][30][31][32][33]. In addition, MW can also be used to predict and evaluate therapeutic effects [34][35][36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Afterload-related reference values for myocardial work indices

Li¹,

Wang

Feng

et al. 2021

Preprint

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Background The novel noninvasive pressure-strain loop (PSL) is a reliable tool that reflects myocardial work (MW). Systolic blood pressure (SBP) is the only independent factor for MW indices. However, afterload-related reference values have not been previously reported. The aim of the present study was to establish reference values for MW parameters by SBP grading over a wide range. Methods We prospectively selected healthy individuals and subjects with SBP ≥ 140mmHg at the time of study without myocardial remodeling. MW parameters were collected and the reference values achieved were grouped by SBP in 10-mmHg. Results Significant differences were noted among the SBP-groups for global work index (GWI) and global constructive work (GCW). The majority of statistical comparisons of the differences in GWI and GCW were significant at each SBP-group. With SBP ranging from 90 to 189mmHg, the parameters GWI and GCW tended to increase linearly with afterload. Overall, the global wasted work (GWW) tended to rise as SBP was increased, but not all of the differences noted in GWW were significant for each SBP-group. Global work efficiency (GWE) remained stable across all SBP-groups, with the exception of a slight drop noted when it exceeded 160 mmHg. Conclusions The amount of MW but not the work efficiency varied greatly according to the different afterload. This finding cannot be ignored during clinical research or diagnosis and afterload-related reference values are required to make a reasonable judgment on the myocardial function.

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“…In the field of echocardiography, there was a significant effort in developing methods aiming at assessing mechanical intraventricular dyssynchrony, and identifying patients with the greatest potential benefit from CRT implantation [ 38 , 39 ].…”

Section: New Ultrasound Technologies For Cardiac Resynchronization Therapymentioning

confidence: 99%

“…LV mechanical discoordination is a time-independent feature which improves the prediction of CRT response rather than mechanical dyssynchrony [ 47 , 48 ]. By using 2D STE in patients with LBBB, it is possible to identify the typical pattern of mechanical discoordination, characterized by early, rapid contraction of the septum and simultaneous passive stretching of the lateral wall, which begins and finishes its contraction later [ 39 , 49 ]. This classic pattern is predictive of response to CRT [ 50 ].…”

Section: New Ultrasound Technologies For Cardiac Resynchronization Therapymentioning

confidence: 99%

“…One of the promising areas of the new ultrasound technologies in CRT is the optimization of the LV electrode implantation, in order to identify the most appropriate LV site to pace, avoiding stimulation of transmural scar tissue [ 39 ]. Patients with LV lead placed in scar-free regions have better survival and less HF hospitalizations than patients with LV lead located in scarred regions [ 44 , 53 , 54 ].…”

Section: New Ultrasound Technologies For Cardiac Resynchronization Therapymentioning

confidence: 99%

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Left Ventricular Deformation and Vortex Analysis in Heart Failure: From Ultrasound Technique to Current Clinical Application

et al. 2021

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Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality. However, its symptoms and signs are not specific or can be absent. In this context, transthoracic echocardiography plays a key role in diagnosing the various forms of HF, guiding therapeutic decision making and monitoring response to therapy. Over the last few decades, new ultrasound modalities have been introduced in the field of echocardiography, aiming at better understanding the morpho-functional abnormalities occurring in cardiovascular diseases. However, they are still struggling to enter daily and routine use. In our review article, we turn the spotlight on some of the newest ultrasound technologies; in particular, analysis of myocardial deformation by speckle tracking echocardiography, and intracardiac flow dynamics by color Doppler flow mapping, highlighting their promising applications to HF diagnosis and management. We also focus on the importance of these imaging modalities in the selection of responses to cardiac resynchronization therapy.

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Current Role of Echocardiography in Cardiac Resynchronization Therapy: from Cardiac Mechanics to Flow Dynamics Analysis

Cited by 13 publications

References 51 publications

Afterload-related reference values for myocardial work indices

Afterload-related reference values for myocardial work indices

Afterload-related reference values for myocardial work indices

Left Ventricular Deformation and Vortex Analysis in Heart Failure: From Ultrasound Technique to Current Clinical Application

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