Abstract 12339: Global Longitudinal Strain as a Risk Marker of Ventricular Arrthythmias in Candidates for Cardiac Resynchronization Therapy
Background: Preimplant predictors of ventricular arrhythmia (VA) in cardiac resynchronization therapy (CRT) candidates are not fully explored. Echocardiographic strain is a sensitive method for quantification of myocardial function and has been shown to be a predictor of VA in cardiomyopathies. We aimed to explore the impact of left ventricular (LV) function, assessed by speckle tracking strain echocardiography, on VA in heart failure patients treated with CRT.
Methods: We investigated heart failure patients eligible for CRT with LV ejection fraction (EF) ≤ 35%, QRS > 120 ms and NYHA functional class 2-4. Echocardiography was performed before and 6 months after CRT implantation. Myocardial function was assessed as EF by Simpson biplane method and global longitudinal strain (GLS) using 2D speckle tracking technique. VA was defined as non-sustained or sustained ventricular tachycardia / fibrillation during 2 years follow up from CRT implantation.
Results: We included 73 patients (age 64±10 years, NYHA class 2.8±0.4, EF 28±9%), 44% had ischemic and 56% had non-ischemic cardiomyopathy. VA occurred in 19 patients (26%) during 24 [11-24] months of follow up. LV function by GLS was lower in patients with VA compared to those without VA during follow-up, both before (-6.5±3.9% vs. -8.8±3.6%, p=0.03) (Figure) and 6 months after CRT implantation ([[Unable to Display Character: ‐]]5.9±5.8% vs. [[Unable to Display Character: ‐]]9.7±4.7%, p=0.01). EF was not a marker of VA, neither before (26±10% vs. 29±9%, p=0.26) nor 6 months after CRT implantation (36±8 vs. 41±12%, p=0.18).
Conclusion: Myocardial function by GLS before CRT implantation was a marker of subsequent VA in CRT candidates, while EF was not. We suggest that GLS may be used in addition to EF as a tool for risk prediction of VA in CRT candidates.
- © 2013 by American Heart Association, Inc.