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- Publisher Website: 10.1016/j.amjcard.2013.11.059
- Scopus: eid_2-s2.0-84896694427
- PMID: 24462070
- WOS: WOS:000333476700013
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Article: Effect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imaging
Title | Effect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imaging |
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Authors | |
Keywords | Aged Echocardiography/*methods Female Follow-Up Studies Heart Failure/physiopathology/*therapy/ultrasonography Heart Ventricles/physiopathology/*ultrasonography Humans Male Myocardial Revascularization/*methods Stroke Volume Treatment Outcome Ventricular Function, Left/*physiology *Ventricular Remodeling |
Issue Date | 2014 |
Citation | The American Journal of Cardiology, 2014, v. 113 n. 6, p. 982-987 How to Cite? |
Abstract | Cardiac resynchronization therapy (CRT) induces left ventricular (LV) reverse remodeling by synchronizing LV mechanical activation. We evaluated changes in segmental LV activation after CRT and related them to CRT response. A total of 292 patients with heart failure (65 +/- 10 years, 77% men) treated with CRT underwent baseline echocardiographic assessment of LV volumes and ejection fraction. Time-to-peak radial strain was measured for 6 midventricular LV segments with speckle-tracking strain imaging. Moreover, the time difference between the peak radial strain of the anteroseptal and the posterior segments was calculated to obtain LV dyssynchrony. After 6 months, LV volumes, segmental LV mechanical activation timings, and LV dyssynchrony were reassessed. Response to CRT was defined as >/=15% decrease in LV end-systolic volume at 6-month follow-up. Responders (n = 177) showed LV resynchronization 6 months after CRT (LV dyssynchrony from 200 +/- 127 to 85 +/- 86 ms; p <0.001) by earlier activation of the posterior segment (from 438 +/- 141 to 394 +/- 132 ms; p = 0.001) and delayed activation of the anteroseptal segment (from 295 +/- 155 to 407 +/- 138 ms; p <0.001). In contrast, nonresponders (n = 115) experienced an increase in LV dyssynchrony 6 months after CRT (from 106 +/- 86 to 155 +/- 112 ms; p = 0.001) with an earlier activation of posterior wall (from 391 +/- 139 to 355 +/- 136 ms; p = 0.039) that did not match the delayed anteroseptal activation (from 360 +/- 148 to 415 +/- 122 ms; p = 0.001). In conclusion, responders to CRT showed LV resynchronization through balanced lateral and anteroseptal activations. In nonresponders, LV dyssynchrony remains, by posterior wall preactivation and noncompensatory delayed septal wall activation. |
Persistent Identifier | http://hdl.handle.net/10722/207690 |
ISSN | 2023 Impact Factor: 2.3 2023 SCImago Journal Rankings: 0.950 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Auger, D | en_US |
dc.contributor.author | Hoke, U | en_US |
dc.contributor.author | Thijssen, J | en_US |
dc.contributor.author | Abate, E | en_US |
dc.contributor.author | Yiu, KH | en_US |
dc.contributor.author | Ewe, SH | en_US |
dc.contributor.author | Witkowski, TG | en_US |
dc.contributor.author | Leong, DP | en_US |
dc.contributor.author | Holman, ER | en_US |
dc.contributor.author | Ajmone Marsan, N | en_US |
dc.contributor.author | Schalij, MJ | en_US |
dc.contributor.author | Bax, JJ | en_US |
dc.contributor.author | Delgado, V | en_US |
dc.date.accessioned | 2015-01-19T04:20:04Z | - |
dc.date.available | 2015-01-19T04:20:04Z | - |
dc.date.issued | 2014 | en_US |
dc.identifier.citation | The American Journal of Cardiology, 2014, v. 113 n. 6, p. 982-987 | en_US |
dc.identifier.issn | 0002-9149 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/207690 | - |
dc.description.abstract | Cardiac resynchronization therapy (CRT) induces left ventricular (LV) reverse remodeling by synchronizing LV mechanical activation. We evaluated changes in segmental LV activation after CRT and related them to CRT response. A total of 292 patients with heart failure (65 +/- 10 years, 77% men) treated with CRT underwent baseline echocardiographic assessment of LV volumes and ejection fraction. Time-to-peak radial strain was measured for 6 midventricular LV segments with speckle-tracking strain imaging. Moreover, the time difference between the peak radial strain of the anteroseptal and the posterior segments was calculated to obtain LV dyssynchrony. After 6 months, LV volumes, segmental LV mechanical activation timings, and LV dyssynchrony were reassessed. Response to CRT was defined as >/=15% decrease in LV end-systolic volume at 6-month follow-up. Responders (n = 177) showed LV resynchronization 6 months after CRT (LV dyssynchrony from 200 +/- 127 to 85 +/- 86 ms; p <0.001) by earlier activation of the posterior segment (from 438 +/- 141 to 394 +/- 132 ms; p = 0.001) and delayed activation of the anteroseptal segment (from 295 +/- 155 to 407 +/- 138 ms; p <0.001). In contrast, nonresponders (n = 115) experienced an increase in LV dyssynchrony 6 months after CRT (from 106 +/- 86 to 155 +/- 112 ms; p = 0.001) with an earlier activation of posterior wall (from 391 +/- 139 to 355 +/- 136 ms; p = 0.039) that did not match the delayed anteroseptal activation (from 360 +/- 148 to 415 +/- 122 ms; p = 0.001). In conclusion, responders to CRT showed LV resynchronization through balanced lateral and anteroseptal activations. In nonresponders, LV dyssynchrony remains, by posterior wall preactivation and noncompensatory delayed septal wall activation. | en_US |
dc.language | eng | en_US |
dc.relation.ispartof | The American Journal of Cardiology | en_US |
dc.subject | Aged | en_US |
dc.subject | Echocardiography/*methods | en_US |
dc.subject | Female | en_US |
dc.subject | Follow-Up Studies | en_US |
dc.subject | Heart Failure/physiopathology/*therapy/ultrasonography | en_US |
dc.subject | Heart Ventricles/physiopathology/*ultrasonography | en_US |
dc.subject | Humans | en_US |
dc.subject | Male | en_US |
dc.subject | Myocardial Revascularization/*methods | en_US |
dc.subject | Stroke Volume | en_US |
dc.subject | Treatment Outcome | en_US |
dc.subject | Ventricular Function, Left/*physiology | en_US |
dc.subject | *Ventricular Remodeling | en_US |
dc.title | Effect of cardiac resynchronization therapy on the sequence of mechanical activation assessed by two-dimensional radial strain imaging | en_US |
dc.type | Article | en_US |
dc.identifier.email | Yiu, KH: khkyiu@hku.hk | en_US |
dc.identifier.authority | Yiu, KH=rp01490 | en_US |
dc.identifier.doi | 10.1016/j.amjcard.2013.11.059 | en_US |
dc.identifier.pmid | 24462070 | - |
dc.identifier.scopus | eid_2-s2.0-84896694427 | - |
dc.identifier.hkuros | 254843 | - |
dc.identifier.volume | 113 | en_US |
dc.identifier.issue | 6 | en_US |
dc.identifier.spage | 982 | en_US |
dc.identifier.epage | 987 | en_US |
dc.identifier.isi | WOS:000333476700013 | - |
dc.identifier.issnl | 0002-9149 | - |