Tissue doppler imaging is superior to strain rate imaging and postsystolic shortening in the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy

Yu, Chaoping; Fung, Jeffrey Wing‐Hong; Zhang, Q.

doi:10.1016/j.accreview.2004.10.030

Cited by 168 publications

(309 citation statements)

References 13 publications

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“…The standard deviations (SD) of TTP Sys and TTP Dia of radial and long-axis velocities in the 16 regions of the 16-segment AHA model were used to evaluate the extent of myocardial dyssynchrony. This approach is analogous to the method described by Yu et al (17) using echocardiography and more recently applied to the evaluation of MR tagging data by Rosen et al (7). Due to the complexity of rotation in basal myocardial segments with several velocity peaks in systole and diastole, we did not further analyze segmental TTP rotation.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Föll

Jung²,

Germann

et al. 2011

Magnetic Resonance Imaging

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Purpose: To employ magnetic resonance tissue phase mapping (TPM) for the assessment of age-related left ventricular (LV) synchrony of radial and long-axis motion in healthy volunteers and in hypertensive heart disease, dilated cardiomyopathy (DCM), and left bundle branch block (LBBB).Materials and Methods: TPM (spatial/temporal resolution ¼ 1.3 Â 2.6 mm 2 /13.8 msec) was employed to measure radial and long-axis myocardial velocities in 58 healthy volunteers of three age groups and 37 patients (hypertensive, n ¼ 18; DCM, n ¼ 12; DCM and LBBB n ¼ 7). Regional times-to-peak velocities (TTP) in systole and diastole were derived for all LV segments. Four measures of dyssynchrony were defined as the standard deviation of systolic and diastolic TTP for radial and long-axis motion.Results: Systolic radial and diastolic long-axis dyssynchrony was increased (P < 0.01) in all patient groups compared to controls. Multiple regressions revealed a significant relationship of dyssynchrony with LV ejection fraction and mass for systolic radial (P < 0.001 resp. P ¼ 0.02), diastolic radial (P < 0.001 resp. P < 0.05), and long-axis (P < 0.001 resp. P ¼ 0.001) motion. Diastolic dyssynchrony correlated with the LV remodeling index (P < 0.05) and increased with age (P < 0.03). Systolic long-axis dyssynchrony was not influenced by disease or LV function. Conclusion:Radial systolic and long-axis diastolic dyssynchrony were the most sensitive markers for altered dyssynchrony in hypertensive heart disease or DCM. Future studies are needed to evaluate the diagnostic value of TPM-derived dyssynchrony parameters.

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Section: Discussionmentioning

confidence: 99%

“…In multiple previous studies based on tissue Doppler imaging, long-axis velocities were easier to access and have been preferred (17). In contrast, parameters of radial contraction of only few myocardial segments were included in most of the earlier reports (8,9).…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Föll

Jung²,

Germann

et al. 2011

Magnetic Resonance Imaging

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“…Standard deviation of the TS (TS-SD) was assumed as the LV dyssynchrony index. 15,16 Myocardial strain curves were reconstituted offline from the TDI color images. An elliptic region of interest (ROI), 12 × 6 mm, was used with careful alignment of the cursor along the direction of the wall in any given region measured.…”

Section: Echocardiographic Protocolmentioning

confidence: 99%

Tricuspid Annular Plane Systolic Excursion Evaluation Improves Selection of Cardiac Resynchronization Therapy Patients

Cappelli

Porciani

Ricceri

et al. 2010

Clinical Cardiology

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Background: The beneficial effects of cardiac resynchronization therapy (CRT) on left ventricular (LV) remodeling have been extensively described. Few data are available about the effects of CRT on right ventricular (RV) function and remodeling. Hypothesis: We hypothesized that CRT could also induce reverse remodeling in the right ventricle and that RV baseline functional status expressed as tricuspidal annular plane systolic excursion (TAPSE) could affect CRT response. Methods: Echocardiographic investigation was performed before and 6 months after CRT. In 192 patients, TAPSE, LV, and RV dimensions with functional parameters and LV dyssynchrony index were evaluated. Results: At 6 months' follow-up, 86 patients (45%) were responders to CRT according to at least 15% LV endsystolic volume reduction. Among baseline echocardiographic parameters, responders had significantly lower TAPSE, larger LV volumes, and higher LV dyssynchrony index. In responders, LV volume reduction, ejection fraction increase, and mitral regurgitation improvement were associated with RV dimensions reduction, increased TAPSE, and improved LV dyssynchrony. Receiver operating characteristic curve analysis showed that TAPSE, at 17 mm optimal cutoff, yielded 64% sensitivity and 60% specificity in predicting CRT response; similarly, LV dyssynchrony index, at 41.25 ms optimal cutoff, predicted CRT response with 60% sensitivity and 62% specificity. A subgroup analysis demonstrated that the coexistence of high TAPSE and high dyssynchrony index values increased probability of CRT response. Conclusions: Our results show that CRT induces RV and LV reverse remodeling and that CRT patient selection can be improved by simply measuring TAPSE value. IntroductionCongestive heart failure (CHF) is a major disorder associated with poor quality of life and high mortality. 1 At present, cardiac resynchronization therapy (CRT) is a new, well-established therapeutic strategy for patients with drugrefractory symptoms, advanced left ventricular (LV) systolic dysfunction, and wide QRS. 2 -7 However, because it was primarily developed to improve function and synchronism of the LV, the effects of CRT on right ventricular (RV) function have not been fully examined.The importance of the right ventricle has often been underestimated; it was long considered mainly as a conduit and the importance of its contractile performance was undervalued. Nowadays, few data are available about the effects of CRT on RV function and remodeling. 8 -10 Moreover, data about the relationship between baseline RV functional status and long-term LV reverse remodeling

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“…Regarding echocardiographic definition of response to CRT, a decrease in LVESV of at least 15% defined remodeling responders [13].…”

Section: Definition Of Crt Respondersmentioning

confidence: 99%

Cardiac resynchronization therapy is effective even in elderly patients with comorbidities

António

Lourenço

Teixeira

et al. 2009

J Interv Card Electrophysiol

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Purpose The purpose of this study was to compare the effects of cardiac resynchronization therapy (CRT) in elderly patients (≥65 years) with younger patients and to assess the impact of comorbidities in CRT remodeling response. Methods This is a prospective study of 87 consecutive patients scheduled for CRT who underwent clinical and echocardiographic evaluation before and 6 months after CRT. A reduction in left ventricular end-systolic volume (LVESV) ≥15% after CRT defined remodeling responders, and a reduction of at least one New York Heart Association class defined clinical responders. Multivariate analysis was used to identify independent predictors of non-response to CRT in terms of reverse remodeling. Results The mean age was 62±11 years, with 36 elderly patients (41%). The baseline QRS duration was 145± 32 ms. After CRT, there were significant and similar improvements of left ventricular (LV) ejection fraction, LVESV, LV dP/dt, and mitral regurgitation jet area (JA) between elderly (≥65 years) and younger (<65 years) patients. The number of clinical and remodeling responders was comparable, and we found no significant differences in unplanned cardiac hospitalizations at 6 months between groups. Independent predictors of lack of remodeling response to CRT were QRS duration <120 ms, LV diastolic diameter >74 mm, and JA >10 cm 2 before CRT, but not comorbidities.Conclusion This work suggests that being elderly is not an impediment to CRT success even in the presence of comorbidities.

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Tissue doppler imaging is superior to strain rate imaging and postsystolic shortening in the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy

Cited by 168 publications

References 13 publications

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Tricuspid Annular Plane Systolic Excursion Evaluation Improves Selection of Cardiac Resynchronization Therapy Patients

Cardiac resynchronization therapy is effective even in elderly patients with comorbidities

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