Pilot study using 3D–longitudinal strain computation in a multi-parametric approach for best selecting responders to cardiac resynchronization therapy

Bibliographic Details
Title: Pilot study using 3D–longitudinal strain computation in a multi-parametric approach for best selecting responders to cardiac resynchronization therapy
Authors: Maxime Fournet, Anne Bernard, Sylvestre Marechaux, Elena Galli, Raphael Martins, Philippe Mabo, J. Claude Daubert, Christophe Leclercq, Alfredo Hernandez, Erwan Donal
Source: Cardiovascular Ultrasound, Vol 15, Iss 1, Pp 1-10 (2017)
Publisher Information: BMC, 2017.
Publication Year: 2017
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: Three-dimensional echocardiography, Heart failure, Cardiac resynchronization therapy, Dyssynchrony, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Abstract Background Almost all attempts to improve patient selection for cardiac resynchronization therapy (CRT) using echo-derived indices have failed so far. We sought to assess: the performance of homemade software for the automatic quantification of integral 3D regional longitudinal strain curves exploring left ventricular (LV) mechanics and the potential value of this tool to predict CRT response. Methods Forty-eight heart failure patients in sinus rhythm, referred for CRT-implantation (mean age: 65 years; LV-ejection fraction: 26%; QRS-duration: 160 milliseconds) were prospectively explored. Thirty-four patients (71%) had positive responses, defined as an LV end-systolic volume decrease ≥15% at 6-months. 3D–longitudinal strain curves were exported for analysis using custom-made algorithms. The integrals of the longitudinal strain signals (I L,peak) were automatically measured and calculated for all 17 LV-segments. Results The standard deviation of longitudinal strain peak (SDI L,peak ) for all 17 LV-segments was greater in CRT responders than non-responders (1.18% s−1 [0.96; 1.35] versus 0.83% s−1 [0.55; 0.99], p = 0.007). The optimal cut-off value of SDI L,peak to predict response was 1.037%.s−1. In the 18-patients without septal flash, SDI L,peak was significantly higher in the CRT-responders. Conclusions This new automatic software for analyzing 3D longitudinal strain curves is avoiding previous limitations of imaging techniques for assessing dyssynchrony and then its value will have to be tested in a large group of patients.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1476-7120
Relation: http://link.springer.com/article/10.1186/s12947-017-0107-6; https://doaj.org/toc/1476-7120
DOI: 10.1186/s12947-017-0107-6
Access URL: https://doaj.org/article/da511b17d01c4368a3241c9eeb526e71
Accession Number: edsdoj.511b17d01c4368a3241c9eeb526e71
Database: Directory of Open Access Journals
More Details
ISSN:14767120
DOI:10.1186/s12947-017-0107-6
Published in:Cardiovascular Ultrasound
Language:English