Validation of an echocardiographic multiparametric strategy to increase responders patients after cardiac resynchronization: a multicentre study

Lafitte, Stéphane; Réant, Patricia; Zaroui, Amira; Donal, Erwan; Mignot, Aude; Bougted, Hannan; Belghiti, Hasnaa; Bordachar, Pierre; Deplagne, Antoine; Chabaneix, Julie; Franceschi, Frédéric; Deharo, Jean‐Claude; Santos, Pierre Dos; Clémenty, Jacques; Roudaut, R.; Leclercq, Christophe; Habib, Gilbert

doi:10.1093/eurheartj/ehn582

Cited by 57 publications

(31 citation statements)

References 29 publications

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“…The number of studies that include more advanced statistical tools is rather limited. Multiple stepwise logistic regression was previously used within the context of our application ( Mädler et al, 2003 ), and multiparametric approaches were proposed to predict response to cardiac resynchronization therapy (CRT) ( Santaularia-Tomas and Abraham, 2009;Lafitte et al, 2009 ). Nonetheless, all these approaches have notable limits for the advanced diagnosis of complex diseases.…”

Section: Multiple Features Analysismentioning

confidence: 99%

Characterization of myocardial motion patterns by unsupervised multiple kernel learning

Sanchez-Martinez

Duchateau

Erdei

et al. 2017

Medical Image Analysis

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We propose an independent objective method to characterize different patterns of functional responses to stress in the heart failure with preserved ejection fraction (HFPEF) syndrome by combining multiple temporally-aligned myocardial velocity traces at rest and during exercise, together with temporal information on the occurrence of cardiac events (valves openings/closures and atrial activation). The method builds upon multiple kernel learning, a machine learning technique that allows the combination of data of different nature and the reduction of their dimensionality towards a meaningful representation (output space). The learning process is kept unsupervised, to study the variability of the input traces without being conditioned by data labels. To enhance the physiological interpretation of the output space, the variability that it encodes is analyzed in the space of input signals after reconstructing the velocity traces via multiscale kernel regression. The methodology was applied to 2D sequences from a stress echocardiography protocol from 55 subjects (22 healthy, 19 HFPEF and 14 breathless subjects). The results confirm that characterization of the myocardial functional response to stress in the HFPEF syndrome may be improved by the joint analysis of multiple relevant features.

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Section: Multiple Features Analysismentioning

confidence: 99%

Characterization of myocardial motion patterns by unsupervised multiple kernel learning

Sanchez-Martinez

Duchateau

Erdei

et al. 2017

Medical Image Analysis

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“…In the study by Gorcsan et al (30), combination of longitudinal and radial measures by speckle tracking predicted EF response significantly better than either technique alone. Recently, Lafitte et al (31) demonstrated that use of a multiparametric approach that focused on criteria combination Table 1. Carluccio et al Remodeling and Recovery of Function After CRT significantly decreased the rate of false-positive results.…”

Section: Figure 3 Relationship Between Baseline Esvi Intravd and Imentioning

confidence: 99%

Presence of Extensive LV Remodeling Limits the Benefits of CRT in Patients With Intraventricular Dyssynchrony

Carluccio

Biagioli

Alunni

et al. 2011

JACC: Cardiovascular Imaging

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“…From another report, it is thought that at least 3 parameters are needed for a reasonable prediction. 54 Suffoletto et al proposed that speckle tracking applied to mid-ventricular short-axis images to calculate the radial strain from multiple circumferential points averaged to 6 segments. 55 The time difference in the peak septal-to-posterior wall strain of ≥130 ms predicted a significant increase in LVEF with a sensitivity of 89% and a specificity of 83%.…”

Section: In Post Prospect Eramentioning

confidence: 99%

Mechanical Dyssynchrony Is Not Everything of Substrate but Is Essential for Cardiac Resynchronization Therapy - Is Assessment of Mechanical Dyssynchrony Necessary in Determining CRT Indication? (Pro) -

Kanzaki

2011

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ardiac resynchronization therapy (CRT) is a treatment for refractory heart failure that uses a specialized pacemaker to re-coordinate or resynchronize the contraction of the both ventricles by pacing multisite in the heart. According to the latest guidelines, CRT is recommended for patients with end-stage heart failure (New York Heart Association (NYHA) class III or IV) despite optimal medical therapy, left ventricular (LV) ejection fraction (EF) ≤35% and wide QRS complex. 1,2 The presence of a conduction delay that includes left bundle branch block (LBBB) is a poor prognostic marker in heart failure. 3 Therefore, CRT can be deemed 'electrical bypass' from the rationale.The acute effects of CRT include an increase in blood pressure, LV max dP/dt and cardiac output 4,5 without an increase in O2 consumption, 6 as well as a reduction of mitral regurgitation (MR) immediately after pacing. 7, 8 The chronic effects of CRT include improvements in functional capacity and symptoms in 70% of heart failure patients, an increase in LVEF, and a decrease of LV end-systolic volume at 6 months and a reduction in the death or heart failure re-admission rates by 30% to 40% at a mean follow-up period of 29 months. 9-12However, despite these promising results, 30-45% of patients selected based on the most recent guidelines do not respond to CRT. 13 Because CRT is an invasive treatment, candidates with severe heart failure should be carefully selected to ensure a maximal benefit with minimal risk. Accordingly, a reliable marker is needed for determining CRT indication. Mechanism of CRTCazeau et al reported in 1994 that multisite pacing increased cardiac output and decreased pulmonary capillary wedge pressure in a patient with LBBB (QRS duration of 200 ms and PR interval of 200 ms) and NYHA IV heart failure, who improved to status to NYHA II 6 weeks later. 14 This is the first reported case of CRT and it is important to think about what type of defect was restored by the pacing in this patient.Patients in whom we are sure that CRT will be effective with a high probability have the following factors: apparent motion by which the LV apex is pulled toward the basal lateral Cardiac resynchronization therapy (CRT) improves heart failure symptoms, cardiac function and long-term prognosis. As a result, it has been established as a treatment for refractory heart failure by using a specialized pacemaker to restore coordinated ventricular contractions with pacing. Despite being an invasive treatment, however, the above effects are not observed in 30-45% of patients selected based on the standard criteria that includes New York Heart Association class III or IV heart failure, left ventricular ejection fraction ≤35%, and QRS duration ≥120 or 130 ms. From the fact that quantifiable resynchronization was associated with hemodynamic and clinical improvements, it should follow that mechanical dyssynchrony is a critical substrate for the benefits from CR...

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Validation of an echocardiographic multiparametric strategy to increase responders patients after cardiac resynchronization: a multicentre study

Abstract: A multiparametric echocardiographic strategy based on the association of conventional criteria is a better indicator of CRT response than the existing single parametric approaches.

Cited by 57 publications

References 29 publications

Characterization of myocardial motion patterns by unsupervised multiple kernel learning

Characterization of myocardial motion patterns by unsupervised multiple kernel learning

Presence of Extensive LV Remodeling Limits the Benefits of CRT in Patients With Intraventricular Dyssynchrony

Mechanical Dyssynchrony Is Not Everything of Substrate but Is Essential for Cardiac Resynchronization Therapy - Is Assessment of Mechanical Dyssynchrony Necessary in Determining CRT Indication? (Pro) -

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