Usefulness of echocardiographic tissue synchronization imaging to predict acute response to cardiac resynchronization therapy.
Echocardiographic tissue synchronization imaging (TSI) consists of color-coding time-to-peak tissue Doppler velocities. This study of 29 patients who underwent cardiac resynchronization therapy (CRT) demonstrated that differences in baseline time-to-speak velocities of opposing ventricular walls by TSI were greater in 15 patients, with an acute hemodynamic improvement. A >/=65 ms delay from the anterior septum to the posterior wall using the apical long-axis view had 87% sensitivity and 100% specificity for predicting an acute response. Although a subgroup without acute improvement had later decreases in end-systolic volume, suggesting that acute response underestimates long-term effects, TSI has potential to assist in guiding CRT.
Gorcsan
John
J
University of Pittsburgh, Pittsburgh, Pennsylvania, USA. gorcsanj@msx.upmc.edu
Kanzaki
Hideaki
H
Bazaz
Raveen
R
Dohi
Kaoru
K
Schwartzman
David
D
D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D002037:Bundle-Branch Block / Q000000981:diagnostic imaging / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007089:Image Enhancement; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology