Combined myocardial deformation to predict cardiac resynchronization therapy response in nonischemic cardiomyopathy.
Background 20-30% of patients do not benefit from cardiac resynchronization therapy (CRT) when the established selection criteria were applied. We hypothesized that a combined assessment of mechanical dyssynchrony, myocardial deformation, and diastolic function would identify patients who would bene...
| Published in: | Pacing & Clinical Electrophysiology Vol. 40; no. 9; pp. 986 - 995 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Sep2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125298665&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125298665 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Sep2017 vid: 40 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 125298665 125298665 125298665 10.1111/pace.13151 125298665 ppf: 986 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Combined myocardial deformation to predict cardiac resynchronization therapy response in nonischemic cardiomyopathy. aug: au: Yang, Ning Liang, Zhao ‐ Guang Wang, Zhao ‐ Jun Liu, Hui Chi, Chao Tian, Yan ‐ Feng Qi, Shu ‐ Han Wang, Bi ‐ Yu Han, Wei affil: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, P. R. China sug: subj: Cardiac Resynchronization Therapy Evaluation Myocardium Anatomy and Histology Myocardial Diseases Diagnosis Human Treatment Outcomes Patient Selection Cardiac Patients Evaluation Control Group Echocardiography Ventricular Function, Left Evaluation Bundle-Branch Block After Care Patient Assessment Diastolic Pressure Evaluation Ventricular Remodeling Middle Age Aged Middle Aged: 45-64 years Aged: 65+ years ab: Background 20-30% of patients do not benefit from cardiac resynchronization therapy (CRT) when the established selection criteria were applied. We hypothesized that a combined assessment of mechanical dyssynchrony, myocardial deformation, and diastolic function would identify patients who would benefit most from CRT. Method In 36 CRT patients, clinical evaluation and echocardiography were performed before and after CRT. Patients were classified into three subgroups according to their amount of response: echocardiographic responders, clinical responders, and nonresponders. Radial dyssynchrony and left ventricular (LV) global longitudinal, radial, and circumferential peak strain was assessed by speckle-tracking image. Diastolic function was quantified by conventional echocardiography. Result In addition to left bundle branch block, nonspecific intraventricular conduction disturbance with intraventricular dyssynchrony could also improve LV remodeling. Echocardiographic responders had better global longitudinal strain, global circumferential peak strain, and global radial strain at baseline which significantly increased at 12-month follow-up. An improvement in estimates of LV filling pressure and a decrease in mitral regurgitation and left atrial dimensions were observed only in echocardiographic responders to CRT. Patients with clinical but without echocardiographic response showed a significant improvement in atrioventricular (AV) synchrony and a nonsignificant improvement in other parameters. The nonresponder group did not improve the AV and intraventricular dyssynchrony. CRT could not improve restrictive filling pattern with normal filling time. Overall, those patients with AV and intraventricular dyssynchrony and those with best contractile function and short diastolic filling time of restrictive filling pattern at baseline demonstrated the greatest benefit from CRT. Conclusions Mechanical dyssynchrony, contractile function, and filling pattern are important determinants of the benefits in CRT. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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