Abstract 14412: Area Strain Delay Index by Three-dimensional Speckle Tracking Imaging Predicts Left Ventricular Reverse Remodeling with Cardiac Resynchronization Therapy
Background: The longitudinal strain delay index by two-dimensional speckle tracking strain is reportedly a marker of both dyssynchrony and residual myocardial contractility. A newly developed three-dimensional (3-D) speckle tracking system can quantify area strain, which coupled with the factors of both longitudinal and circumferential strain, from all 16 standard left ventricular (LV) segments using complete 3-D pyramidal datasets.
Hypothesis: We assessed the hypothesis that strain delay index using area tracking (ASDI) can qualify dyssynchrony and predict reverse remodeling after cardiac resynchronization therapy (CRT).
Methods: We studied 7 patients with ejection fraction 27±8% (all≤35%) and QRS 179±31ms (all≥120ms) who underwent CRT before and 6-month after CRT. ASDI was calculated as the average difference between peak and end-systolic area strain of LV endocardium from 16-segment using 3-D speckle tracking imaging. Conventional dyssynchrony measures were assessed by interventricular mechanical delay, Yu Index, and radial dyssynchrony using two-dimensional speckle tracking radial strain as the antero-septum and posterior wall delay.
Results: CRT improved end-systolic volume (ESV) from 131±98 to 107±86ml (p<0.01). There was no correlation between baseline conventional dyssynchrony measures and the reduction of ESV with CRT. However, baseline ASDI significantly correlated with the reduction of ESV with CRT (r=0.78, p<0.05).
Conclusions: ASDI can successfully predict LV reverse remodeling with CRT. This new index may have clinical implications in CRT patients.
- © 2010 by American Heart Association, Inc.