Heart failureUsefulness of Tissue Doppler Velocity and Strain Dyssynchrony for Predicting Left Ventricular Reverse Remodeling Response After Cardiac Resynchronization Therapy
Section snippets
Methods
Two hundred fifty-six patients with heart failure (mean age 65.3 ± 11.2 years; 74% men) who received CRT at 3 different centers were included in the study. The mean follow-up duration was 6 ± 3 months. The inclusion criteria for CRT were compatible with current guidelines, including New York Heart Association class III (88%) or IV (12%) heart failure despite optimal pharmacologic therapy, evidence of LV systolic dysfunction (LV ejection fraction <35%), and QRS duration >120 ms. The causes of
Results
There were reductions in LV end-diastolic (p <0.001) and end-systolic (p <0.001) volumes, with improvements in LV ejection fractions (p <0.001), after CRT (Table 1). A response of LV reverse remodeling was defined as a reduction in LV end-systolic volume of ≥15%,7, 8, 14 which was observed in 141 patients (55%). The other 115 patients (45%), who had reductions in LV end-systolic volume <15%, were classified as nonresponders. The baseline LV sizes and ejection fractions were similar between
Discussion
This study is the largest to date that examined the predictive values of TDI-derived echocardiographic parameters of intraventricular dyssynchrony on LV reverse remodeling after CRT, with data collected from 3 independent centers. Also, the present study compared a large number of myocardial longitudinal velocity and strain parameters of dyssynchrony in the same study population. With this approach, the superiority of longitudinal tissue Doppler velocity over tissue Doppler strain parameters of
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