Τίτλος:
Echocardiography for prediction of 6-month and late response to cardiac resynchronization therapy: implementation of stress echocardiography and comparative assessment along with widely used dyssynchrony indices
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Non-response cardiac resynchronization therapy (CRT) remains an issue, despite the refinement of selection criteria. The purpose of this study was to investigate the role of stress echocardiography along with dyssynchrony parameters for identification of CRT responders or late responders. 106 symptomatic heart failure patients were examined before, 6 months and 2–4 years after CRT implementation. Inotropic contractile reserve (ICR) and inferolateral (IL) wall viability were studied by stress echocardiography. Dyssynchrony was assessed by: (1) Septal to posterior wall motion delay (SPWMD) by m-mode. (2) Septal to lateral wall delay (SLD) by TDI. (3) Interventricular mechanical delay (IVMD) by pulsed wave Doppler for (4) difference in time to peak circumferential strain (TmaxCS) by speckle tracking. (5) Apical rocking (ApR) and septal flash (SF) by visual assessment. At 6 months there were 54 responders, with 12 additional late responders. TmaxCS had the greatest predictive value with an area under curve (AUC) of 0.835, followed by the presence of both ICR and viability of IL wall (AUC 0.799), m-mode (AUC = 0.775) and presence of either ApR or SF (AUC = 0.772). Predictive ability of ApR and of ICR is augmented if late responders are also included. Performance of dyssynchrony parameters is enhanced, in patients with both ICR and IL wall viability. Stress echocardiography and dyssynchrony parameters are simple and reliable predictors of 6-month and late CRT response. A stepwise approach with an initial assessment of ICR and viability and, if positive, further dyssynchrony analysis, could assist decision making. © 2019, Springer Nature B.V.
Συγγραφείς:
Poulidakis, E.
Aggeli, C.
Sideris, S.
Sfendouraki, E.
Koutagiar, I.
Katsaros, A.
Giannoulis, E.
Koukos, M.
Margioula, E.
Lagoudakou, S.
Gatzoulis, K.
Dilaveris, P.
Kallikazaros, I.
Couloheri, S.
Stefanadis, C.
Tousoulis, D.
Περιοδικό:
The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
Εκδότης:
SPRINGER NETHERLANDS
Λέξεις-κλειδιά:
dobutamine; beta 1 adrenergic receptor stimulating agent; dobutamine, aged; area under the curve; Article; cardiac resynchronization therapy; cardiovascular parameters; comparative study; controlled study; female; heart disease; heart failure; heart left ventricle ejection fraction; human; inferolateral wall viability; inotropic contractile reserve; interventricular mechanical delay; low drug dose; major clinical study; male; New York Heart Association class; pacemaker implantation; predictive value; prospective study; pulsed Doppler ultrasonography; QRS interval; reliability; septal to lateral wall motion delay; septal to posterior wall motion delay; stress echocardiography; time to peak circumferential strain; time to treatment; treatment response; color Doppler echocardiography; computer assisted diagnosis; convalescence; diagnostic imaging; heart contraction; heart left ventricle function; heart right ventricle function; middle aged; pathophysiology; predictive value; procedures; stress echocardiography; time factor; treatment outcome, Adrenergic beta-1 Receptor Agonists; Aged; Cardiac Resynchronization Therapy; Dobutamine; Echocardiography, Doppler, Color; Echocardiography, Stress; Female; Heart Failure; Humans; Image Interpretation, Computer-Assisted; Male; Middle Aged; Myocardial Contraction; Predictive Value of Tests; Recovery of Function; Time Factors; Treatment Outcome; Ventricular Function, Left; Ventricular Function, Right
DOI:
10.1007/s10554-018-01520-6
