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Cardiac imaging and non-invasive testing
Improvement of left ventricular myocardial short-axis, but not long-axis function or torsion after cardiac resynchronisation therapy: an assessment by two-dimensional speckle tracking
  1. Q Zhang,
  2. J W-H Fung,
  3. G W K Yip,
  4. J Y-S Chan,
  5. A P-W Lee,
  6. Y-Y Lam,
  7. L-W Wu,
  8. E B Wu,
  9. C-M Yu
  1. Division of Cardiology, SH Ho Cardiovascular and Stroke Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
  1. Professor Cheuk-Man Yu, Division of Cardiology, Institute of Vascular Medicine, SH Ho Cardiovascular and Stroke Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong; cmyu{at}cuhk.edu.hk

Abstract

Aims: To evaluate whether short-axis function plays a part in determining left ventricular (LV) geometric and functional improvement after cardiac resynchronisation therapy (CRT).

Methods and results: 39 patients who received CRT were enrolled. 2D speckle tracking echocardiography was performed at baseline and three months after CRT to assess mean systolic circumferential (ϵ-circum), radial (ϵ-radial) and longitudinal (ϵ-long) strain and torsion. Responders of reverse remodelling (n = 21) had higher baseline mean ϵ-circum than non-responders (p<0.05), who also had improvement in mean ϵ-circum and mean ϵ-radial (both p<0.05) after CRT. Also, the increase in mean ϵ-circum correlated with increase in ejection fraction (r = 0.57, p<0.001) and decrease in mid-cavity width (r = −0.52, p = 0.001). A baseline mean ϵ-circum of ⩾6.5% predicted a gain in ejection fraction ⩾5%, with a sensitivity of 73% and a specificity of 71%. The baseline ϵ-long was not different between the two groups, and remained unchanged after CRT. The torsion did not improve in responders, but was worsened in non-responders (p<0.05).

Conclusions: The improvement of LV short-axis function but not long-axis function or torsion contributes to the improvement in LV global function and geometry at three-month follow up. A relatively preserved mean ϵ-circum of ⩾6.5% might be useful to predict favourable responses after CRT.

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Footnotes

  • Competing interests: None.

  • Funding: Supported by a research grant from Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong and the SH Ho Cardiovascular and Stroke Centre.

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