Has mechanical dyssynchrony still a role in predicting cardiac resynchronization therapy response?

Echocardiography
Maria Cristina PorcianiLuigi Padeletti

Abstract

Current guidelines for cardiac resynchronization therapy (CRT) include electrical but not mechanical dyssynchrony assessment. Our study aims to investigate the effects of isolated or combined mechanical and electrical dyssynchrony, according, respectively, to a standard deviation of tissue Doppler imaging (TDI) derived time to systolic peak ≥32.6 ms and to a QRS duration ≥120 ms, in predicting CRT reverse remodeling. One hundred ninety-two CRT patients were studied. All patients underwent a complete standard and TDI echocardiography examination before and 6 months after CRT. According to baseline evaluation patients were divided into Group 1, patients with isolated electrical dyssynchrony (QRS ≥ 120 ms, TS-SD < 32.6), Group 2, patients with isolated mechanical dyssynchrony (QRS < 120 ms, TS-SD ≥ 32.6) and Group 3, patients with combined electrical and mechanical dyssynchrony (QRS ≥ 120 ms, TS-SD ≥ 32.6). Patients were considered CRT responders according to ≥15 left ventricular end-systolic volume (LVESV) reduction at follow-up (FU). At FU, 86 (45%) patients were responders. The highest CRT response rate was observed in Group 3 (62/119, 52%, P < 0.001 vs. Group 1). No significant differences in response rate were observed betwee...Continue Reading

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Citations

Nov 2, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Maria Cristina PorcianiLuigi Padeletti
May 3, 2011·Heart Failure Reviews·Luigi PadelettiEdoardo Gronda
Feb 22, 2012·Echocardiography·Viviane Tiemi HottaMarcelo L C Vieira
Aug 1, 2014·Clinical Physiology and Functional Imaging·Paola AttanàLuigi Padeletti
Apr 5, 2014·Journal of Cardiovascular Medicine·Luigi PadelettiClaudio Luchinat

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