Abstract 8921: Prediction of Response to Heart Failure Therapy in Patients With Dilated Cardiomyopathy: A Two-Dimensional Ultrasound Speckle Tracking Study.
Backround: The aim of the study was to assess the value of newer echocardiographic parameters of regional myocardial function for prediction of response to heart failure therapy in patients with dilated cardiomyopathy (DCM).
Methods: Fourty-five patients (mean age 48 ± 14 years) with DCM, defined as ejection fraction (EF) < 45 %, left ventricular (LV) enddiastolic diameter (LVEDd) > 27 mm/m2BSA and normal coronary angiogram, underwent echocardiograpic examination. EF, LVEDd and endiastolic LV volume were measured. Greyscale cine-loops were obtained from three apical views (4-chamber, 2-chamber and apical long axis). Based on two-dimensional ultrasound speckle tracking echocardiography following parameters were extracted: strain (S), systolic (SRs) and diastolic strain rate (SRe). The parameters were expressed as mean values between all views. In all patients an acute or chronic active myocarditis was excluded by ECG, troponin I and myocardial biopsy. After receiving heart failure therapy for more than 6 months (mean 15 , range 6 — 31) an improvement of EF (> 10 %) was observed in 15 patients. In 26 patients optimal medical treatment did not lead to an increase in EF. Four patients, who received a CRT pacemaker, were excluded.
Results: The area under the ROC-curves of different parameters are displayed in table 1.
Conclusions: In this small, prospective study, SRe, which measures regional diastolic relaxation, was the best predictor of response to heart failure therapy in patients with DCM, being superior to LV dimensions and QRS duration. Parameters of systolic deformation (S and SRs) failed to predict improvement of LV function.
- © 2010 by American Heart Association, Inc.