Utility of three-dimensional echocardiography in assessing and predicting response to cardiac resynchronization therapy

Lau, Ching; Abdel‐Qadir, Husam; Lashevsky, Ilan; Hansen, Mark; Crystal, Eugene; Joyner, Campbell

doi:10.1016/s0828-282x(10)70451-7

Cited by 8 publications

(3 citation statements)

References 27 publications

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“…For quantitative dyssynchrony evaluation, the LV is most commonly divided into 16 or 17 segments as per the American Heart Association standard model [85], and the time to minimum systolic volume is determined for each segment. Several small studies have suggested that an increased dyssynchrony index prior to implant is predictive of response to CRT [86][87][88][89][90], and that placement of the LV lead near the most delayed segment may be associated with favorable LV remodeling [91], but these findings have not been consistent [92,93]. Several small studies have suggested that an increased dyssynchrony index prior to implant is predictive of response to CRT [86][87][88][89][90], and that placement of the LV lead near the most delayed segment may be associated with favorable LV remodeling [91], but these findings have not been consistent [92,93].…”

Section: Dyssynchrony Analysismentioning

confidence: 99%

Evaluation of left ventricular structure and function by three-dimensional echocardiography

Bhave

Lang

2013

Current Opinion in Critical Care

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With real-time 3DTTE, one can acquire and display a 3D image encompassing the entire LV within seconds. Because 3DTTE aids in identification of the true LV apex, it provides more accurate LV volumes than its 2D counterpart. As compared with a cardiovascular magnetic resonance standard, 3DTTE tends to slightly underestimate LV volumes, in part because its spatial resolution is limited, making identification of the true endocardial border more difficult. As compared with 2DTTE, 3DTTE is advantageous for identifying and assessing the extent of regional wall motion abnormalities. For quantification of LV mass, 3DTTE is superior to both 2DTTE and M-mode echocardiography. Emerging applications of 3DTTE include speckle-tracking strain assessment, dyssynchrony analysis, and LV shape analysis, which appear to have prognostic value in patients with a variety of cardiac conditions.

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Section: Dyssynchrony Analysismentioning

confidence: 99%

Evaluation of left ventricular structure and function by three-dimensional echocardiography

Bhave

Lang

2013

Current Opinion in Critical Care

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“…The standard deviation of the regional times to minimum systolic volume has been proposed as the dyssynchrony index [ 77 ]. Several small studies have suggested that an increased dyssynchrony index prior to implant is predictive of favorable response to CRT [ 78 – 81 ] and that placement of the LV lead near the most delayed segment may be associated with favorable LV remodeling [ 82 ], but these findings have not been consistent [ 83 , 84 ]. It is clear that greater degrees of LV dysfunction are associated with higher dyssynchrony indices [ 77 , 85 – 87 ], but this may be due to noisy, low-amplitude ejection curves as much as true dyssynchrony [ 21 , 85 ].…”

Section: Assessment Of Left Ventricular Geometry and Function Withmentioning

confidence: 99%

The Clinical Benefits of Adding a Third Dimension to Assess the Left Ventricle with Echocardiography

Badano

2014

Scientifica

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Three-dimensional echocardiography is a novel imaging technique based on acquisition and display of volumetric data sets in the beating heart. This permits a comprehensive evaluation of left ventricular (LV) anatomy and function from a single acquisition and expands the diagnostic possibilities of noninvasive cardiology. It provides the possibility of quantitating geometry and function of LV without preestablished assumptions regarding cardiac chamber shape and allows an echocardiographic assessment of the LV that is less operator-dependent and therefore more reproducible. Further developments and improvements for widespread routine applications include higher spatial and temporal resolution to improve image quality, faster acquisition, processing and reconstruction, and fully automated quantitative analysis. At present, three-dimensional echocardiography complements routine 2DE in clinical practice, overcoming some of its limitations and offering additional valuable information that has led to recommending its use for routine assessment of the LV of patients in whom information about LV size and function is critical for their clinical management.

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“…More recently, Lau and colleagues 17 performed realtime 3D echocardiography before implantation of the CRT pacemaker, 24 hours after implantation and six to 12 months after implantation.…”

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confidence: 99%

A Guide to the Use of Left Ventricular Analysis with 3D Echo in Dyssynchrony

Passaretti¹,

Sganzerla²,

Lucca³

et al. 2011

European Cardiology Review

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Data from single-centre studies suggest that echocardiographic parameters of mechanical dyssynchrony may improve patient selection for cardiac resynchronisation therapy (CRT). To our knowledge, the only published multicentre trial that compared 12 echocardiographic methods, the Predictors of response to cardiac resynchronization therapy (PROSPECT) trial, stated that none of the echocardiographic measurements of ventricular dyssynchrony applied in the study were able to distinguish responders from non-responders. Realtime 3D echocardiography is able to measure left ventricular (LV) size, function and dyssynchrony to identify the presence and extension of scar tissue and to evaluate where the site of latest mechanical activation is. After CRT device implantation, it also allows physicians to detect where the first mechanical activation secondary to LV pacing is located. Indeed, it can be useful in interventricular (VV) delay optimisation of the device after the implantation and, in single-centre studies, it was able to predict response to CRT and to identify responders from non-responders. Care must be taken to optimise temporal resolution, but now volume rates of 70–80vps can be easily obtained in the majority of cases. VV optimisation using realtime 3D echocardiography is feasible and intuitive, but time-consuming compared with traditional methods based on Doppler or algorithms. In this article we illustrate our approach to LV analysis with realtime 3D echocardiography in the study of dyssynchrony.

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Utility of three-dimensional echocardiography in assessing and predicting response to cardiac resynchronization therapy

Cited by 8 publications

References 27 publications

Evaluation of left ventricular structure and function by three-dimensional echocardiography

Evaluation of left ventricular structure and function by three-dimensional echocardiography

The Clinical Benefits of Adding a Third Dimension to Assess the Left Ventricle with Echocardiography

A Guide to the Use of Left Ventricular Analysis with 3D Echo in Dyssynchrony

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