Imaging and Diagnostic TestingDoppler myocardial imaging in patients with heart failure receiving biventricular pacing treatment☆
Section snippets
Inclusion criteria
We studied all patients with HF with an indication for BIV implantation who were referred to our institution from January to December 1999 and who subsequently underwent successful implantation. The inclusion criteria were patients with advanced HF, still symptomatic (class III or IV) after optimized drug treatment involving diuretics, ACE inhibitors at the maximum tolerable dose, and β-blockers; patients with LV systolic dysfunction, defined by ejection fraction <40%; and patients with
Qualitative TDI patterns before BIV
The following qualitative patterns of regional electromechanical disease were identified by TDI analysis.
Pattern I was defined as the normal M-mode color and PW-TDI pattern at the basal level of each LV wall (Figure 1, A and B). In M-mode color TDI (Figure 1, A), the contraction and relaxation phases are consistent with a homogeneous alternance of red and blue bands. The diastolic phase (EAR) lengthens more than the systolic phase plus the active relaxation time (COMR). The ER and AR waves are
Discussion
Our results show that TDI technique can be useful in assessing LV asynchrony in patients with HF with LBBB as well as LV resynchronization after BIV. In our series, the regional LV asynchrony improved in 34% of the LV basal segments, corresponding to the 47.6% of our patients. Such an improvement in the LV regional function was paralleled by an improvement in the LV performance, as documented by a significant increase in the LVEF and exercise tolerance data in group 1 compared with group 2
Acknowledgements
We thank Mrs Mary Rendall for having helped us in reviewing the manuscript.
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