Evaluation of left ventricular mechanical dyssynchrony in chronic heart failure patients by two‐dimensional speckle tracking imaging

Abstract

The purpose of this study was to evaluate left ventricular mechanical dyssynchrony (LVMD) in chronic heart failure (CHF) patients using two-dimensional speckle tracking imaging (2D-STI), and also to compare the usefulness of three patterns of myocardial deformation in mechanical dyssynchrony assessment. Furthermore, the relationships between left ventricular ejection fraction (LVEF), QRS duration (QRSd), and LVMD were explored. In total, 78 patients and 60 healthy individuals (group 3) were enrolled. The patients were classified into two subgroups: LVEF≤35% (group 1), 35%<LVEF<50% (group 2). All participants underwent two-dimensional echocardiography, and dyssynchrony indices derived from 2D-STI were calculated. According to statistical principles, the cut-off value of LVMD was defined as mean±1.645 SD of the normal population. Dyssynchrony rates were calculated in CHF subgroups and compared within each subgroup, respectively. Compared with group 3, all indices in group 1 were remarkably higher (p<0.05), and some of the indices in group 2 were significantly higher (p<0.05). A significant difference of dyssynchrony rate was noted within both group 1 and group 2 (χ(2)=25.55, p<0.05 vs. χ(2)=23.88, p<0.05), and the highest value was derived from the longitudinal index in both subgroups. LVEF was related to all three forms of strain/strain rate (p<0.05), whereas no relationship existed between QRSd and dyssynchrony indices (p>0.05). CHF patients have different extents of LVMD. Longitudinal deformation shows the best detectability of dyssynchrony motion. Left ventricular systolic function was closely related to mechanical dyssynchrony, whereas QRSd showed no significant correlation.

Temporal changes within mechanical dyssynchrony and rotational mechanics in Takotsubo syndrome: A cardiovascular magnetic resonance imaging study

“…Despite dyssynchrony resolution, EF and strain impairment have also been demonstrated by echocardiography [ 27 ] and CMR [ 28 ] and represent important aspects of LV recovery [ 28 ] in TTS. This observation is also paralleled by the correlation of URE and EF and in accordance with previously reported observations in chronic heart failure [ 29 ]. Although CURE and RURE have been demonstrated to equally differentiate between healthy controls and non-ischemic cardiomyopathy subjects [ 15 ], within the current study, CURE had higher correlation values with LVEF and was more affected within the acute phase as compared to RURE.…”

Evaluation of Cardiac Mechanical Dyssynchrony in Heart Failure Patients Using Current Echo-Doppler Modalities

“…Our study revealed no significant correlations between QRS duration and both LV dimensions, volumes, or LV systolic function (either by 2-D or 4-D). Concordantly, Jiang et al 18) found no relationship between QRS duration and LV systolic function.…”

Clinical Utility of Three-Dimensional Speckle-Tracking Echocardiography in Heart Failure

“…Although LV mechanical dyssynchrony is associated with improved cardiac function after CRT, responses to post-CRT therapy are hard to predict and can be absent in as many as one-third of patients. The selection of optimal candidates for CRT can be assisted by echocardiographic assessment of LV mechanical dyssynchrony [ 17 , 68 , 69 ]. M-mode, pulsed Doppler and TDI methods have yielded mixed results in predicting CRT response, while STE has emerged as a new method for predicting treatment outcomes in CRT patients through the measurement of myocardial deformation [ 32 , 69 ].…”