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Left ventricular 12 segmental strain imaging predicts response to cardiac resynchronization therapy

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Background The number of non-responders to cardiac resynchronization therapy (CRT) exposes the need for better patient selection criteria for CRT.This study aimed to identify echocardiographic parameters that would predict the response to CRT.Methods Forty-five consecutive patients receiving CRT-D implantation for heart failure (HF) were included in this prospective study.New York Heart Association (NYHA) class,6-minute walk distance,electrograph character,and multi echocardiographic parameters,especially in strain patterns,were measured and compared before and six months after CRT in the responder and non-responder groups.Response to CRT was defined as a decrease in left ventricular endsystolic volume (LVESV) of 15% or more at 6-month follow up.Results Twenty-two (48.9%) patients demonstrated a response to CRT at 6-month follow-up.Significant improvement in NYHA class (P <0.01),left ventricular end-diastolic volume (LVEDV) (P <0.01),and 6-minute walk distance (P <0.01) was shown in this group.Although there was an interventricular mechanical delay determined by the difference between left and right ventricular pre-ejection intervals ((42.87±19.64) ms vs.(29.43±18.19) ms,P=0.02),the standard deviation of time to peak myocardial strain among 12 basal,mid and apical segments (Tε-SD) ((119.97±43.32) ms vs.(86.62±36.86) ms,P=0.01) and the non-ischemic etiology (P=0.03) were significantly higher in responders than non-responders,only the Tε-SD (OR=1.02,95% Cl=1.01-1.04,P=0.02) proved to be a favorable predictor of CRT response after multivariate Logistic regression analysis.Conclusion The left ventricular 12 segmental strain imaging is a promising echocardiographic parameter for predicting CRT response.

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作者单位: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA;Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China [1] Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA [2] Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China [3]
期刊: 《中华医学杂志(英文版)》2013年126卷14期 2620-2624页 SCIMEDLINEISTICCSCDBP
栏目名称: ORIGINAL ARTICLES
DOI: 10.3760/cma.j.issn.0366-6999.20122125
发布时间: 2013-09-09
基金项目:
This study was supported by a grant from the National Natural Science Foundation of China (NSFC)
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