Abstract 12393: Tissue Doppler Imaging Dyssynchrony Parameter Based on the First Active Wall Motion Improve Ability in Predicting Responders of Cardiac Resynchronization Therapy
Background: Intravenricular dyssynchrony parameters by tissue Doppler imaging (TDI) are assessed only during ejection period in predicting responders of cardiac resynchronization therapy (CRT). In contrast, septal active wall motion is often observed during pre-ejection period in patients with dyssynchrony. The aim of this study was to assess the ability of modified TDI parameters using peak velocities derived from the first active wall motion which were measured by including pre-ejection period, compared to standard TDI derived parameters.
Methods: Sixty-one patients (EF 27±9%, QRS 165±39ms) referred for CRT were enrolled. The time from QRS onset to peak velocities by TDI (Ts) only during ejection period were assessed to calculate following dyssynchrony parameters; the standard deviation of Ts in 12 left ventricular (LV) segments (Ts-SD) and the differences of Ts between septum and lateral wall (Ts-SL). In addition, modified Ts was assessed as the time to peak velocity, which was derived from active wall motion identified by longitudinal strain rate value, during pre- and ejection period, and to calculate modified- Ts-SD and Ts-SL. Responders of CRT were defined as patients with LV end-systolic volume reduction (>15%) at 6 months after CRT.
Results: Thirty-five patients (57%) were identified as responders of CRT. Cut off value that provided best separation between responders and non-responders, sensitivity and specificity to predict responders, area under the curve (AUC) by receiver-operating characteristics (ROC) analysis (figure). Both modified-Ts-SD and Ts-SL improved accuracy to predict CRT responders compared to standard Ts-SD and Ts-SL.
Conclusions: Modified TDI dyssynchrony parameters which were measured during pre-ejection period addition to ejection period considering septal first active wall motion improve ability in predicting responders of CRT.
- © 2010 by American Heart Association, Inc.