Abstract 10104: Easy-to-Use Comprehensive Speckle Tracking Evaluation to Minimize Non-Responders Following Cardiac Resynchronization Therapy
Background: Left ventricular (LV) dyssynchrony has emerged as an important mechanism contributing to response to cardiac resynchronization therapy (CRT), but other potential factors, especially LV myocardial viability, can also influence response to CRT. Therefore, an approach combining assessment of LV dyssynchrony and myocardial viability may well be required.
Methods: We studied 132 patients undergoing CRT. LV dyssynchrony was determined by the anteroseptal-to-posterior wall delay from mid-LV short-axis view using two-dimensional speckle-tracking radial strain (≥130ms as significant). Global circumferential strain (GCS), considered as a parameter of intrinsic LV myocardial function, was also determined as the peak global circumferential strain from the same view. Long-term follow-up was tracked over 3.0 years.
Results: Kaplan-Meier curve indicated that patients with GCS<-3.91% experienced fewer cardiovascular events in overall patients (log-rank p=0.047). Similarly, patients with GCS<-3.91% and ≤-6.56% experienced fewer cardiovascular events than those with GCS≥-3.91% and >-6.56% in patients with and without LV dyssynchrony (log-rank p=0.037 and p=0.023, respectively). Furthermore, the prevalence of event-free survival in patients with GCS<-3.91% and GCS≤-6.56% was significantly higher than that in patients with GCS≥-3.91% GCS>-6.56% in patients with and without LV dyssynchrony (86% vs. 64%, p=0.028 and 88% vs. 43%, p=0.018, respectively). An important finding of multivariate Cox proportional-hazards analysis was that LV dyssynchrony and GCS were the independent predictor of cardiovascular events. Of note, only 2±1 minutes per patient were needed to analyze both LV dyssynchrony and GCS from routine same mid-LV short axis view.
Conclusions: This easy-to-use combined assessment of LV dyssynchrony and myocardial function using speckle-tracking strain from the same mid-LV short axis view may well have clinical implications for CRT.
- © 2013 by American Heart Association, Inc.