Systolic Stretch Characterizes the Electromechanical Substrate Responsive to Cardiac Resynchronization Therapy

JACC. Cardiovascular Imaging
John GorcsanJoost Lumens

Abstract

In this study, the authors tested the hypotheses that the systolic stretch index (SSI) developed by computer modeling and applied using echocardiographic strain imaging may characterize the electromechanical substrate predictive of outcome following cardiac resynchronization therapy (CRT). They included patients with QRS width 120 to 149 ms or non-left bundle branch block (LBBB), where clinical uncertainty for CRT exists. They further tested the hypothesis that global longitudinal strain (GLS) has additional prognostic value. Response to CRT is variable. Guidelines favor patient selection by electrocardiographic LBBB with QRS width ≥150 ms. The authors studied 442 patients enrolled in the Adaptive CRT 94-site randomized trial with New York Heart Association functional class III-IV heart failure, ejection fraction ≤35%, and QRS ≥120 ms. A novel computer program semiautomatically calculated the SSI from strain curves as the sum of posterolateral prestretch percent before aortic valve opening and the septal rebound stretch percent during ejection. The primary endpoint was hospitalization for heart failure (HF) or death, and the secondary endpoint was death over 2 years after CRT. In all patients, high longitudinal SSI (≥ group med...Continue Reading

Citations

Jul 24, 2020·European Heart Journal Cardiovascular Imaging·Odette A E SaldenMaarten J Cramer
Sep 19, 2020·European Heart Journal·Frits W Prinzen, Joost Lumens
Jan 27, 2021·International Journal of Environmental Research and Public Health·Michał OrszulakKatarzyna Mizia-Stec
Feb 7, 2021·The International Journal of Cardiovascular Imaging·Philippe C WoutersBart W L De Boeck
Nov 27, 2020·European Heart Journal Supplements : Journal of the European Society of Cardiology·Giovanni La Canna, Iside Scarfo'
Mar 7, 2020·JACC. Cardiovascular Imaging·Simon CalleFrank Timmermans
Apr 19, 2021·JACC. Cardiovascular Imaging·Simon CalleFrank Timmermans
Jun 21, 2021·JACC. Cardiovascular Imaging·Ole J SlettenHelge Skulstad
Jul 19, 2021·JACC. Cardiovascular Imaging·John GorcsanSoraya Samii
Jul 22, 2021·Circulation. Cardiovascular Imaging·Alwin ZweerinkRobin Nijveldt
Aug 26, 2021·European Heart Journal Cardiovascular Imaging·Elena GalliErwan Donal
Aug 30, 2021·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·Michael GliksonKlaus K Witte
Aug 30, 2021·European Heart Journal·Michael GliksonUNKNOWN ESC Scientific Document Group
Dec 7, 2021·European Heart Journal Cardiovascular Imaging·Philippe C WoutersMaarten J Cramer

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