The Association of a classical left bundle Branch Block Contraction Pattern by vendor-independent strain echocardiography and outcome after cardiac resynchronization therapy.
Background: The association of a Classical left bundle branch block (LBBB) contraction pattern and better outcome after cardiac resynchronization therapy (CRT) has only been studied using vendor-specific software for echocardiographic speckle-tracked longitudinal strain analysis. The purpose of this...
| Publicado en: | Cardiovascular Ultrasound Vol. 17; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
BioMed Central
5/21/2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136557730&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136557730 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14767120 1CJP jtl: Cardiovascular Ultrasound issn: 14767120 maglogo: N pubinfo: dt: 5/21/2019 vid: 17 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 136557730 136557730 NLM31113440 10.1186/s12947-019-0160-4 NLM31113440 136557730 ppf: 1 ppct: 9 formats: tig: atl: The Association of a classical left bundle Branch Block Contraction Pattern by vendor-independent strain echocardiography and outcome after cardiac resynchronization therapy. aug: au: Emerek, Kasper Friedman, Daniel J. Sørensen, Peter L. Hansen, Steen M. Larsen, Jacob M. Risum, Niels Thøgersen, Anna Margrethe Graff, Claus Atwater, Brett D. Kisslo, Joseph Søgaard, Peter affil: Department of Medicine, Division of Cardiology, Duke University Hospital, Durham, NC, USA sug: subj: Myocardial Contraction Physiology Cardiac Resynchronization Therapy Methods Echocardiography Methods Ventricular Function, Left Physiology Business Bundle-Branch Block Physiopathology Heart Ventricle Female Bundle-Branch Block Therapy Prospective Studies Stroke Volume Physiology Aged Retrospective Design Bundle-Branch Block Diagnosis Heart Ventricle Physiopathology Male Electrocardiography Software Image Interpretation, Computer Assisted Scales Aged: 65+ years Female Male ab: Background: The association of a Classical left bundle branch block (LBBB) contraction pattern and better outcome after cardiac resynchronization therapy (CRT) has only been studied using vendor-specific software for echocardiographic speckle-tracked longitudinal strain analysis. The purpose of this study was to assess whether a Classical LBBB contraction pattern on longitudinal strain analysis using vendor-independent software is associated with clinical outcome in CRT recipients with LBBB.Methods: This was a retrospective cohort study including CRT recipients with LBBB, heart failure, and left ventricular (LV) ejection fraction ≤35%. Speckle-tracked echocardiographic longitudinal strain analysis was performed retrospectively on echocardiograms using vendor-independent software. The presence of a Classical LBBB contraction pattern was determined by consensus of two readers. The primary end point was a composite of time to death, heart transplantation or LV assist device implantation. Secondary outcome was ≥15% reduction in LV end-systolic volume. Intra- and inter-reader agreement of the longitudinal strain contraction pattern was assessed by calculating Cohen's κ.Results: Of 283 included patients, 113 (40%) were women, mean age was 66 ± 11 years, and 136 (48%) had ischemic heart disease. A Classical LBBB contraction pattern was present in 196 (69%). The unadjusted hazard ratio for reaching the primary end point was 1.93 (95% confidence interval, 1.36-2.76, p < 0.001) when comparing patients without to patients with a Classical LBBB contraction pattern. Adjusted for ischemic heart disease and QRS duration < 150 milliseconds the hazard ratio was 1.65 (95% confidence interval, 1.12-2.43, p = 0.01). Of the 123 (43%) patients with a follow-up echocardiogram, 64 of 85 (75%) of patients with a Classical LBBB contraction pattern compared to 13 of 38 (34%) without, had ≥15% reduction in LV end-systolic volume (p < 0.001). Cohen's κ were 0.86 (95% confidence interval, 0.71-1.00) and 0.42 (95% confidence interval, 0.30-0.54) for intra- and inter-reader agreement, respectively.Conclusion: Using vendor-independent strain software, a Classical LBBB contraction pattern is associated with better outcome in CRT recipients with LBBB, but inter-reader agreement for the classification of contraction pattern is only moderate. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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