Abstract 3247: Left Ventricular Dyssynchrony Can Lead to Reverse Ventricular Rotation as a Novel Predictor of Response to Cardiac Resynchronization Therapy
Background: Although various echocardiographic parameters have been tried to predict the effectiveness of cardiac resynchronization therapy (CRT), no robust method has been established. Recently, the left ventricular (LV) twisting was found to be playing an important role in systolic LV function. To clarify whether LV twisting abnormality could predict response to CRT, we investigated the LV twisting dynamics in patients with heart failure (HF) and broad QRS complex.
Methods and Results: Twenty-seven patients (aged 67.5±11.9 years) with HF and QRS duration of more than 130ms (151±22 ms) were studied. Apical and basal LV rotations were evaluated using echocardiographic image speckle tracking and the clockwise rotation of the apical wall and/or the counterclockwise rotation of the basal wall were defined as reverse rotation. After undergoing CRT, patients in whom systolic LV volume decreased more than 15% were defined as responder to CRT. Reverse rotation was observed in 14 patients and there were 15 responders and 12 non-responders. Reverse rotation predicted a sensitivity of 85%, a specificity of 76%, and a predictive accuracy of 81% for response to CRT.
Conclusions: About half of patients with HF and broad QRS complex presented LV twisting abnormality. Reverse rotation could be a powerful predictor for response to CRT.