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J Am Coll Cardiol, 2002; 40:723-730
© 2002 by the American College of Cardiology Foundation
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CLINICAL STUDY: DIAGNOSTICS AND HEART FAILURE

Tissue doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy

Peter Søgaard, MD, DMSc*,*, Henrik Egeblad, MD, DMSc, FESC*, W. Yong Kim, MD, PhD*, Henrik K. Jensen, MD, PhD*, Anders K. Pedersen, MD, DMSc*, Bent Ø. Kristensen, MD, DMSc* and Peter T. Mortensen, MD*

* Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Manuscript received September 11, 2001; revised manuscript received April 17, 2002, accepted May 20, 2002.

* Reprint requests and correspondence: Dr. Peter Søgaard, Department of Cardiology, Aarhus University Hospital, DK-8200 Aarhus North, Denmark.
psogaard{at}dadlnet.dk

OBJECTIVES: We sought to evaluate the long-term impact of cardiac resynchronization therapy (CRT) on left ventricular (LV) performance and remodeling using three-dimensional echocardiography and tissue Doppler imaging (TDI).

BACKGROUND: Three-dimensional echocardiography and TDI allow rapid and accurate evaluation of LV volumes and performance.

METHODS: Twenty-five consecutive patients with severe heart failure and bundle branch block who underwent biventricular pacemaker implantation were included. Before and after implantation of the pacemaker, three-dimensional echocardiography and TDI were performed. These examinations were repeated at outpatient visits every six months.

RESULTS: Five patients (20%) died during one-year follow-up. In the remaining 20 patients, significant reductions in LV end-diastolic volume and LV end-systolic volume of 9.6 ± 14% and 16.5 ± 15%, respectively (p < 0.01), could be demonstrated during long-term follow-up. Accordingly, LV ejection fraction increased by 21.7 ± 18% (p < 0.01). According to a newly developed TDI technique—tissue tracking—all regional myocardial segments improved their longitudinal systolic shortening (p < 0.01). The extent of the LV base displaying delayed longitudinal contraction, as detected by TDI before pacemaker implantation, predicted long-term efficacy of CRT. The QRS duration failed to predict resynchronization efficacy.

CONCLUSIONS: Cardiac resynchronization significantly improved LV function and reversed LV remodeling during long-term follow-up. Patients likely to benefit from CRT can be identified by TDI before implantation of a biventricular pacemaker.

Abbreviations and Acronyms
  CRT
  cardiac resynchronization therapy
  DLC
  delayed longitudinal contraction
  GSCA
  global systolic contraction amplitude
  LV
  left ventricle/ventricular
  LVEF
  left ventricular ejection fraction
  NYHA
  New York Heart Association
  RV
  right ventricle/ventricular
  SR
  strain rate
  TDI
  tissue Doppler imaging
  TT
  tissue tracking




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J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2042 - 2048.
[Abstract] [Full Text] [PDF]

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E. Donal, C. Leclercq, C. Linde, and J.-C. Daubert
Effects of cardiac resynchronization therapy on disease progression in chronic heart failure
Eur. Heart J., May 1, 2006; 27(9): 1018 - 1025.
[Abstract] [Full Text] [PDF]

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P. Steendijk, S. A. Tulner, J. J. Bax, P. V. Oemrawsingh, G. B. Bleeker, L. van Erven, H. Putter, H. F. Verwey, E. E. van der Wall, and M. J. Schalij
Hemodynamic Effects of Long-Term Cardiac Resynchronization Therapy: Analysis by Pressure-Volume Loops
Circulation, March 14, 2006; 113(10): 1295 - 1304.
[Abstract] [Full Text] [PDF]

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F. A Flachskampf and J.-U. Voigt
Echocardiographic methods to select candidates for cardiac resynchronisation therapy.
Heart, March 1, 2006; 92(3): 424 - 429.
[Full Text] [PDF]

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 Am. J. Physiol. Heart Circ. Physiol.Home page
X. A. A. M. Verbeek, A. Auricchio, Y. Yu, J. Ding, T. Pochet, K. Vernooy, A. Kramer, J. Spinelli, and F. W. Prinzen
Tailoring cardiac resynchronization therapy using interventricular asynchrony. Validation of a simple model
Am J Physiol Heart Circ Physiol, March 1, 2006; 290(3): H968 - H977.
[Abstract] [Full Text] [PDF]

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M. S. Suffoletto, K. Dohi, M. Cannesson, S. Saba, and J. Gorcsan III
Novel Speckle-Tracking Radial Strain From Routine Black-and-White Echocardiographic Images to Quantify Dyssynchrony and Predict Response to Cardiac Resynchronization Therapy
Circulation, February 21, 2006; 113(7): 960 - 968.
[Abstract] [Full Text] [PDF]

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 Eur J EchocardiogrHome page
M. C. Porciani, R. Macioce, G. Demarchi, M. Chiostri, N. Musilli, F. Cappelli, A. Lilli, G. Ricciardi, and L. Padeletti
Effects of cardiac resynchronization therapy on the mechanisms underlying functional mitral regurgitation in congestive heart failure
Eur J Echocardiogr, January 1, 2006; 7(1): 31 - 39.
[Abstract] [Full Text] [PDF]

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 Postgrad. Med. J.Home page
S Ellery, L Williams, and M Frenneaux
Role of resynchronisation therapy and implantable cardioverter defibrillators in heart failure
Postgrad. Med. J., January 1, 2006; 82(963): 16 - 23.
[Abstract] [Full Text] [PDF]

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J. J. Bax, T. Abraham, S. S. Barold, O. A. Breithardt, J. W.H. Fung, S. Garrigue, J. Gorcsan III, D. L. Hayes, D. A. Kass, J. Knuuti, et al.
Cardiac Resynchronization Therapy: Part 1--Issues Before Device Implantation
J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2153 - 2167.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
A. Kashani and S. S. Barold
Significance of QRS Complex Duration in Patients With Heart Failure
J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2183 - 2192.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
J. M. Aranda Jr, G. W. Woo, R. S. Schofield, E. M. Handberg, J. A. Hill, A. B. Curtis, S. F. Sears, J. S. Goff, D. F. Pauly, and J. B. Conti
Management of Heart Failure After Cardiac Resynchronization Therapy: Integrating Advanced Heart Failure Treatment With Optimal Device Function
J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2193 - 2198.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
I. Schuster, G. Habib, C. Jego, F. Thuny, J.-F. Avierinos, G. Derumeaux, L. Beck, C. Medail, F. Franceschi, S. Renard, et al.
Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy
J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2250 - 2257.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
P. P. Pham, S. Balaji, I. Shen, R. Ungerleider, X. Li, and D. J. Sahn
Impact of Conventional Versus Biventricular Pacing on Hemodynamics and Tissue Doppler Imaging Indexes of Resynchronization Postoperatively in Children With Congenital Heart Disease
J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2284 - 2289.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
A. M. Feldman, G. de Lissovoy, M. R. Bristow, L. A. Saxon, T. De Marco, D. A. Kass, J. Boehmer, S. Singh, D. J. Whellan, P. Carson, et al.
Cost Effectiveness of Cardiac Resynchronization Therapy in the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Trial
J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2311 - 2321.
[Abstract] [Full Text] [PDF]

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 Eur Heart JHome page
G. Lecoq, C. Leclercq, E. Leray, C. Crocq, C. Alonso, C. d. Place, P. Mabo, and C. Daubert
Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced heart failure
Eur. Heart J., June 1, 2005; 26(11): 1094 - 1100.
[Abstract] [Full Text] [PDF]

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 CirculationHome page
R. H. Helm, C. Leclercq, O. P. Faris, C. Ozturk, E. McVeigh, A. C. Lardo, and D. A. Kass
Cardiac Dyssynchrony Analysis Using Circumferential Versus Longitudinal Strain: Implications for Assessing Cardiac Resynchronization
Circulation, May 31, 2005; 111(21): 2760 - 2767.
[Abstract] [Full Text] [PDF]

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 Eur J Heart FailHome page
A. Bulava, J. Lukl, M. Skvarilova, and D. Marek
Dramatically improved left ventricular function after biventricular pacemaker implantation--a case report
Eur J Heart Fail, March 2, 2005; 7(2): 231 - 233.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
C.-M. Yu, Q. Zhang, J. W.-H. Fung, H. C.-K. Chan, Y.-S. Chan, G. W.-K. Yip, S.-L. Kong, H. Lin, Y. Zhang, and J. E. Sanderson
A novel tool to assess systolic asynchrony and identify responders of cardiac resynchronization therapy by tissue synchronization imaging
J. Am. Coll. Cardiol., March 1, 2005; 45(5): 677 - 684.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
M. V. Pitzalis, M. Iacoviello, R. Romito, P. Guida, E. De Tommasi, G. Luzzi, M. Anaclerio, C. Forleo, and P. Rizzon
Ventricular asynchrony predicts a better outcome in patients with chronic heart failure receiving cardiac resynchronization therapy
J. Am. Coll. Cardiol., January 4, 2005; 45(1): 65 - 69.
[Abstract] [Full Text] [PDF]

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 EuropaceHome page
A. Schuchert, M. A. Aydin, C. Israel, G. Gaby, and V. Paul
Atrial pacing and sensing characteristics in heart failure patients undergoing cardiac resynchronization therapy
Europace, January 1, 2005; 7(2): 165 - 169.
[Abstract] [Full Text] [PDF]

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 Eur J EchocardiogrHome page
S. Saha, J. Nowak, C. Storaa, C.F. Madler, A. Fraser, S. Roumina, B. Lind, and L.-A. Brodin
Functional diagnosis of coronary stenosis using tissue tracking provides best sensitivity and specificity for left circumflex disease: experience from the MYDISE (myocardial Doppler in stress echocardiography) study
Eur J Echocardiogr, January 1, 2005; 6(1): 54 - 63.
[Abstract] [Full Text] [PDF]


 
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