Left ventricular global longitudinal strain in predicting CRT response: one more J-shaped curve in medicine

Orszulak, Michał; Filipecki, Artur; Wróbel, Wojciech; Berger-Kucza, Adrianna; Orszulak, W.; Urbańczyk-Świć, Dagmara; Kwaśniewski, Wojciech; Mizia-Stec, Katarzyna

doi:10.1007/s00380-021-01770-w

Cited by 3 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 Several studies reported baseline global longitudinal strain predicts LV reverse remodeling after CRT in patients with both ischemic and non-ischemic cardiomyopathy. [11][12][13] In our study strain parameters have also significantly improved.…”

Section: Discussionmentioning

confidence: 52%

Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy

Roy,

Haque,

Paul

et al. 2023

Int J Res Med Sci

View full text Add to dashboard Cite

Background: Dilated cardiomyopathy can be treated using cardiac resynchronisation therapy (CRT) effectively. In our study, we compared the clinical and biochemical profile of responders and non-responders to CRT device (CRTD) implantation suffering from DCM. Methods: A cross-sectional observational study was performed in 47 patients with dilated cardiomyopathy for CRTD implantation for a period of 18 months. The tools used for the study include electrocardiography 12 lead, echocardiography: 2D, M mode, Doppler, strain echo, Holter monitoring, coronary angiography and CRTD implantation. Statistical analysis was performed using Epi Info (TM) 7.2.2.2. Results: The proportion of responders (68.1%) was significantly higher than non-responder (31.9%). Almost 60% of patients in non-responder group had smoking as a risk factor. Around 60% were suffering from hypertension and 33% from T2DM in non-respondent group. Parameters of dyssynchrony has significantly improved in responder group than in non-responder group. LVEDV, LVESV has shown an increase and EF has decreased considerably in DCM patients. Many patients in non-responder category have shown mitral and tricuspid regurgitation. Strain echocardiography parameters-GLS, GRS and GCS were significantly decreased. Post CRTD echocardiographic parameter has improved considerably and LVESV was reduced in more than 15% of responders. Conclusions: The CRTD implantation improves patients’ clinical and Echocardiographic data which can help in better patient management, improving quality of life and decreased healthcare cost. By this study we can improve patients’ selection and predict accordingly for CRT responders and non-responders and can take necessary measures for better patient’s management.

show abstract

Section: Discussionmentioning

confidence: 52%

Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy

Roy,

Haque,

Paul

et al. 2023

Int J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…The most common definition of CRT response is that the patient has fewer symptoms and/or better clinical outcomes with this therapy than without it. Interestingly, the most commonly used criterion for CRT efficacy is not LVEF improvement (such as in the assessment of HFimpEF) but LVESV reduction by >15%, because it corelates more accurately with long-term survival in CRT recipients [ 72 , 73 ]. Moreover, there is no defined time frame for CRT assessment.…”

Section: Cardiac Implantable Electronic Device and Hfimpefmentioning

confidence: 99%

Heart Failure with Improved Ejection Fraction: Insight into the Variable Nature of Left Ventricular Systolic Function

Wybraniec

Orszulak

Męcka

et al. 2022

IJERPH

Self Cite

View full text Add to dashboard Cite

The progress of contemporary cardiovascular therapy has led to improved survival in patients with myocardial disease. However, the development of heart failure (HF) represents a common clinical challenge, regardless of the underlying myocardial pathology, due to the severely impaired quality of life and increased mortality comparable with malignant neoplasms. Left ventricular ejection fraction (LVEF) is the main index of systolic function and a key predictor of mortality among HF patients, hence its improvement represents the main indicator of response to instituted therapy. The introduction of complex pharmacotherapy for HF, increased availability of cardiac-implantable electronic devices and advances in the management of secondary causes of HF, including arrhythmia-induced cardiomyopathy, have led to significant increase in the proportion of patients with prominent improvement or even normalization of LVEF, paving the way for the identification of a new subgroup of HF with an improved ejection fraction (HFimpEF). Accumulating data has indicated that these patients share far better long-term prognoses than patients with stable or worsening LVEF. Due to diverse HF aetiology, the prevalence of HFimpEF ranges from roughly 10 to 40%, while the search for reliable predictors and genetic associations corresponding with this clinical presentation is under way. As contemporary guidelines focus mainly on the management of HF patients with clearly defined LVEF, the present review aimed to characterize the definition, epidemiology, predictors, clinical significance and principles of therapy of patients with HFimpEF.

show abstract

Chronic Right Ventricular Pacing Post-Transcatheter Aortic Valve Replacement Attenuates the Benefit on Left Ventricular Function

Chao,

Mandale,

Farina

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Conduction abnormality post-transcatheter aortic valve implantation (TAVI) remains clinically significant and usually requires chronic pacing. The effect of right ventricular (RV) pacing post-TAVI on clinical outcomes warrants further studies. Methods: We identified 147 consecutive patients who required chronic RV pacing after a successful TAVI procedure and propensity-matched these patients according to the Society of Thoracic Surgeons (STS) risk score to a control group of patients that did not require RV pacing post-TAVI. We evaluated routine echocardiographic measurements and performed offline speckle-tracking strain analysis for the purpose of this study on transthoracic echocardiographic (TTE) images performed at 9 to 18 months post-TAVI. Results: The final study population comprised 294 patients (pacing group n = 147 and non-pacing group n = 147), with a mean age of 81 ± 7 years, 59% male; median follow-up was 354 days. There were more baseline conduction abnormalities in the pacing group compared to the non-pacing group (56.5% vs. 41.5%. p = 0.01). Eighty-eight patients (61.6%) in the pacing group required RV pacing due to atrioventricular (AV) conduction block post-TAVI. The mean RV pacing burden was 44% in the pacing group. Left ventricular ejection fraction (LVEF) was similar at follow-up in the pacing vs. non-pacing groups (57 ± 13.0%, 59 ± 11% p = 0.31); however, LV global longitudinal strain (−12.7 ± 3.5% vs. −18.8 ± 2.7%, p < 0.0001), LV apical strain (−12.9 ± 5.5% vs. 23.2 ± 9.2%, p < 0.0001), and mid-LV strain (−12.7 ± 4.6% vs. −18.7 ± 3.4%, p < 0.0001) were significantly worse in the pacing vs. non-pacing groups. Conclusions: Chronic RV pacing after the TAVI procedure is associated with subclinical LV systolic dysfunction within 1.5 years of follow-up.

show abstract

Left ventricular global longitudinal strain in predicting CRT response: one more J-shaped curve in medicine

Cited by 3 publications

References 38 publications

Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy

Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy

Heart Failure with Improved Ejection Fraction: Insight into the Variable Nature of Left Ventricular Systolic Function

Chronic Right Ventricular Pacing Post-Transcatheter Aortic Valve Replacement Attenuates the Benefit on Left Ventricular Function

Contact Info

Product

Resources

About