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Gepubliceerd in: Netherlands Heart Journal 12/2010

01-11-2010 | Original Article

Peak longitudinal strain delay is superior to TDI in the selection of patients for resynchronisation therapy

Auteurs: M.G. Scheffer, P.F.H.M. van Dessel, B.M. van Gelder, G.R. Sutherland, N.M. van Hemel

Gepubliceerd in: Netherlands Heart Journal | Uitgave 12/2010

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Abstract

Background. Mechanical dyssynchrony has proven to be superior to QRS duration in predicting response to cardiac resynchronisation therapy (CRT). Whether time to peak longitudinal strain delay between the mid-septum and mid-lateral left ventricular wall better predicts CRT response than tissue Doppler imaging (TDI) is unclear. This study compares the value of the two methods for the assessment of mechanical dyssynchrony and prediction of CRT responders.
Methods. 66 clinical responders and 17 nonresponders to CRT with severe systolic heart failure (LVEF <35%), New York Heart Association classification III or IV and a wide QRS >130 ms with left bundle branch block were evaluated by peak longitudinal strain and TDI. Doppler echocardiograms and electromechanical time delay (EMD) intervals were acquired before and after pacemaker implantation.
Results. In all responders EMD measured by peak longitudinal strain was >60 ms before implantation, compared with 76% of the patients measured by TDI. Nonresponders had EMD <60 ms measured by both techniques. Only peak longitudinal strain delay showed shortened values in every responder postimplantation and demonstrated the most significant reduction and could predict responders to CRT. However, EMD measured by TDI did not diminish in 30% of the positive clinical responders. Nonresponders showed worsening of the EMD with peak longitudinal strain, but not with TDI.
Conclusions. Responders to CRT can be excellently predicted if EMD before implantation determined by peak longitudinal strain delay is >60 ms. Peak longitudinal strain delay appears to be superior to TDI to predict the response to CRT. (Neth Heart J 2010;18:574–82.)
Literatuur
5.
go back to reference Auricchio A, Stellbrink C, Sack S, et al. The Pacing Therapies for Congestive Heart Failure (PATH-CHF) study: rationale, design and endpoints of a prospective randomized multicenter study. Am J Cardiol. 1999; 83:130D–135D.PubMedCrossRef Auricchio A, Stellbrink C, Sack S, et al. The Pacing Therapies for Congestive Heart Failure (PATH-CHF) study: rationale, design and endpoints of a prospective randomized multicenter study. Am J Cardiol. 1999; 83:130D–135D.PubMedCrossRef
6.
go back to reference Cazeau S, Leclerq C, Lavergne T, et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med. 2001;344:873–880.PubMedCrossRef Cazeau S, Leclerq C, Lavergne T, et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med. 2001;344:873–880.PubMedCrossRef
7.
go back to reference Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002;346:1845–1853.PubMedCrossRef Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002;346:1845–1853.PubMedCrossRef
8.
go back to reference Bristow CR, Saxon LA, Boehmer J, et al. Cardiac resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140–2150.PubMedCrossRef Bristow CR, Saxon LA, Boehmer J, et al. Cardiac resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140–2150.PubMedCrossRef
9.
go back to reference Higgins SL, Hummel JD, Niazi IK, et al. Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias. J Am Coll Cardiol. 2003;42:1454–1459.PubMedCrossRef Higgins SL, Hummel JD, Niazi IK, et al. Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias. J Am Coll Cardiol. 2003;42:1454–1459.PubMedCrossRef
10.
go back to reference Fried AG, Parker AB, Newton GE, et al. Electrical and hemodynamic correlates of the maximal rate of pressure increase in the human left ventricle. J Card Fail. 1999;5:8–16.PubMedCrossRef Fried AG, Parker AB, Newton GE, et al. Electrical and hemodynamic correlates of the maximal rate of pressure increase in the human left ventricle. J Card Fail. 1999;5:8–16.PubMedCrossRef
11.
go back to reference Xiao HB, Roy C, Gibson DG. Nature of ventricular activation in patients with dilated cardiomyopathy: evidence for bilateral bundle branch block. Br Heart J. 1994;72:167–174.PubMedCrossRef Xiao HB, Roy C, Gibson DG. Nature of ventricular activation in patients with dilated cardiomyopathy: evidence for bilateral bundle branch block. Br Heart J. 1994;72:167–174.PubMedCrossRef
12.
go back to reference Kass DA. Predicting cardiac resynchronization response by QRS duration: the long and short of it. J Am Coll Cardiol. 2003;42:2125–2127.PubMedCrossRef Kass DA. Predicting cardiac resynchronization response by QRS duration: the long and short of it. J Am Coll Cardiol. 2003;42:2125–2127.PubMedCrossRef
13.
go back to reference Achilli A, Sassara M, Ficili S, et al. Long-term effectiveness of cardiac resynchronization therapy in patients with refractory heart failure and narrow QRS complex. J Am Coll Cardiol. 2003;42:2117–2124.PubMedCrossRef Achilli A, Sassara M, Ficili S, et al. Long-term effectiveness of cardiac resynchronization therapy in patients with refractory heart failure and narrow QRS complex. J Am Coll Cardiol. 2003;42:2117–2124.PubMedCrossRef
14.
go back to reference Turner MS, Blaesdale RA, Vinereanu D, et al. Electrical and Mechanical components of dyssynchrony in heart failure patients with normal QRS duration and left bundle branch block: impact of left and biventricular pacing. Circulation. 2004;109:2544–2549.PubMedCrossRef Turner MS, Blaesdale RA, Vinereanu D, et al. Electrical and Mechanical components of dyssynchrony in heart failure patients with normal QRS duration and left bundle branch block: impact of left and biventricular pacing. Circulation. 2004;109:2544–2549.PubMedCrossRef
15.
go back to reference Leclerq C, Faris O, Tunin R, et al. Systolic improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block. Circulation. 2002;106:1760–1763.CrossRef Leclerq C, Faris O, Tunin R, et al. Systolic improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block. Circulation. 2002;106:1760–1763.CrossRef
16.
go back to reference Bleeker GB, Schalij MJ, Molhoek SG, et al. Relationship between QRS duration and left ventricular dyssynchrony in patients with end-stage heart failure. J Cardiovasc Electrophysiol. 2004;15:544–549.PubMedCrossRef Bleeker GB, Schalij MJ, Molhoek SG, et al. Relationship between QRS duration and left ventricular dyssynchrony in patients with end-stage heart failure. J Cardiovasc Electrophysiol. 2004;15:544–549.PubMedCrossRef
17.
go back to reference Sutherland GR, Hatle L, Claus P, et al. Normal regional strain rate / strain curves. In: Doppler Myocardial Imaging a Textbook. BSWK bvba, Hasselt, Belgium 2006, Chapter 4: p.68–76. Sutherland GR, Hatle L, Claus P, et al. Normal regional strain rate / strain curves. In: Doppler Myocardial Imaging a Textbook. BSWK bvba, Hasselt, Belgium 2006, Chapter 4: p.68–76.
18.
go back to reference Bax JJ, Molhoek SG, van Erven, et al. Usefulness of myocardial tissue Doppler echocardiography to evaluate left ventricular dyssynchrony before and after biventricular pacing in patients with idiopathic dilated cardiomyopathy. Am J Cardiol. 2003:91:94–97.PubMedCrossRef Bax JJ, Molhoek SG, van Erven, et al. Usefulness of myocardial tissue Doppler echocardiography to evaluate left ventricular dyssynchrony before and after biventricular pacing in patients with idiopathic dilated cardiomyopathy. Am J Cardiol. 2003:91:94–97.PubMedCrossRef
19.
go back to reference Bax JJ, Marwick TH, Molhoek SG, et al. Left ventricular dyssynchrony predicts benefit of cardiac resynchronization therapy in patients with end stage heart failure before pacemaker implantation. Am J Cardiol. 2003;92:1238–1240.PubMedCrossRef Bax JJ, Marwick TH, Molhoek SG, et al. Left ventricular dyssynchrony predicts benefit of cardiac resynchronization therapy in patients with end stage heart failure before pacemaker implantation. Am J Cardiol. 2003;92:1238–1240.PubMedCrossRef
20.
go back to reference Yu CM, Fung WH, Lin H, et al. Predictors of left ventricular reverse remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy. Am J Cardiol. 2003;91:684–688.PubMedCrossRef Yu CM, Fung WH, Lin H, et al. Predictors of left ventricular reverse remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy. Am J Cardiol. 2003;91:684–688.PubMedCrossRef
21.
go back to reference Sógaard P, Egeblad H, Kim Y, et al. Tissue Doppler Imaging improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy. J Am Coll Cardiol. 2002;40:723–730.PubMedCrossRef Sógaard P, Egeblad H, Kim Y, et al. Tissue Doppler Imaging improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy. J Am Coll Cardiol. 2002;40:723–730.PubMedCrossRef
22.
go back to reference Soliman Ol, Theuns DA, Geleijnse ML, et al. Spectral pulsedwave tissue Doppler imaging lateral-to-septal delay fails to predict clinical or echocardiographic outcome after cardiac resynchronization therapy. Europace. 2007;9:113–118.PubMedCrossRef Soliman Ol, Theuns DA, Geleijnse ML, et al. Spectral pulsedwave tissue Doppler imaging lateral-to-septal delay fails to predict clinical or echocardiographic outcome after cardiac resynchronization therapy. Europace. 2007;9:113–118.PubMedCrossRef
23.
go back to reference De Boeck BW, Meine M, Leenders GE, et al. Practical and conceptual limitations of tissue Doppler imaging to predict reverse remodeling in cardiac resynchronisation therapy. Eur J Heart Fail. 2008;10:281–290.PubMedCrossRef De Boeck BW, Meine M, Leenders GE, et al. Practical and conceptual limitations of tissue Doppler imaging to predict reverse remodeling in cardiac resynchronisation therapy. Eur J Heart Fail. 2008;10:281–290.PubMedCrossRef
24.
go back to reference Chung Es, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (Prospect) trial. Circulation. 2008;117:2608–2616.PubMedCrossRef Chung Es, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (Prospect) trial. Circulation. 2008;117:2608–2616.PubMedCrossRef
25.
go back to reference Ansalone G, Giannantoni P, Ricci R, et al. Doppler Myocardial Imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing. J Am Coll Cardiol. 2002;39:489–499.PubMedCrossRef Ansalone G, Giannantoni P, Ricci R, et al. Doppler Myocardial Imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing. J Am Coll Cardiol. 2002;39:489–499.PubMedCrossRef
26.
go back to reference Sógaard P, Egeblad H, Pedersen AK, et al. Sequential versus simultaneous biventricular resynchronization for severe heart failure. Evaluation by Tissue Doppler Imaging. Circulation. 2002;106:2078–2084.PubMedCrossRef Sógaard P, Egeblad H, Pedersen AK, et al. Sequential versus simultaneous biventricular resynchronization for severe heart failure. Evaluation by Tissue Doppler Imaging. Circulation. 2002;106:2078–2084.PubMedCrossRef
27.
go back to reference Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantification of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr. 1989;2:358–367.PubMed Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantification of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr. 1989;2:358–367.PubMed
28.
go back to reference Abd El Raman MY, Hui W, Yigitbasi M, et al. Detection of left ventricular asynchrony in patients with right bundle branch block after repair of Tetralogy of Fallot using tissue Doppler imaging derived strain. J Am Coll Cardiol. 2005;45:915–921.CrossRef Abd El Raman MY, Hui W, Yigitbasi M, et al. Detection of left ventricular asynchrony in patients with right bundle branch block after repair of Tetralogy of Fallot using tissue Doppler imaging derived strain. J Am Coll Cardiol. 2005;45:915–921.CrossRef
29.
go back to reference Kukulski T, Jamal F, D’Hooge J, et al. Acute changes in systolic and diastolic events during clinical coronary angioplasty: a comparison of regional velocity, strain rate, and strain measurement. J Am Soc Echocardiogr. 2002;15:1–12.PubMedCrossRef Kukulski T, Jamal F, D’Hooge J, et al. Acute changes in systolic and diastolic events during clinical coronary angioplasty: a comparison of regional velocity, strain rate, and strain measurement. J Am Soc Echocardiogr. 2002;15:1–12.PubMedCrossRef
30.
go back to reference Popović ZB, Grimm RA, Perlic G, et al. Noninvasive assessment of cardiac resynchronization therapy for congestive heart failure using myocardial strain and left ventricular peak power as parameters of myocardial synchrony and function. J Cardiovasc Electrophysiol. 2002;13:1203–1208.PubMedCrossRef Popović ZB, Grimm RA, Perlic G, et al. Noninvasive assessment of cardiac resynchronization therapy for congestive heart failure using myocardial strain and left ventricular peak power as parameters of myocardial synchrony and function. J Cardiovasc Electrophysiol. 2002;13:1203–1208.PubMedCrossRef
31.
go back to reference Breithardt OA, Stellbrink C, Herbots L, et al. Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block. J Am Coll Cardiol. 2003;42:486–494.PubMedCrossRef Breithardt OA, Stellbrink C, Herbots L, et al. Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block. J Am Coll Cardiol. 2003;42:486–494.PubMedCrossRef
32.
go back to reference Yu CM, Fung JW, Zhang Q, et al. Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation. 2004;110:66–73.PubMedCrossRef Yu CM, Fung JW, Zhang Q, et al. Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation. 2004;110:66–73.PubMedCrossRef
33.
go back to reference De Boeck BW, Teske AJ, Meine M, et al. Septal rebound stretch reflects the functional substrate to cardiac resynchronisation therapy and predicts volumetric and neurohormonal response. Eur J Heart Fail. 2009;11:863–871.PubMedCrossRef De Boeck BW, Teske AJ, Meine M, et al. Septal rebound stretch reflects the functional substrate to cardiac resynchronisation therapy and predicts volumetric and neurohormonal response. Eur J Heart Fail. 2009;11:863–871.PubMedCrossRef
Metagegevens
Titel
Peak longitudinal strain delay is superior to TDI in the selection of patients for resynchronisation therapy
Auteurs
M.G. Scheffer
P.F.H.M. van Dessel
B.M. van Gelder
G.R. Sutherland
N.M. van Hemel
Publicatiedatum
01-11-2010
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 12/2010
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-010-0838-6

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