Evaluation of ventricular synchrony using novel Doppler echocardiographic indices in patients with heart failure receiving cardiac resynchronization therapy.
Cardiac resynchronization therapy improves hemodynamics in selected patients with heart failure. Mechanic asynchrony parameters that may guide patient selection or therapy optimization are still being investigated. A biventricular (BiV) pacemaker was implanted in 34 patients with dilated ischemic, idiopathic, or valvular cardiomyopathy, and a QRS duration of > or =130 milliseconds. Two-dimensional standard and Doppler tissue echocardiography was performed during right ventricular (RV), left ventricular (LV), BiV, and no pacing in a random and blinded manner. LV and BiV pacing increased stroke volume (P <.02 for both) and ejection fraction (P <.001 for both). Regional contractility assessed by displacement, strain rate, and peak systolic strain was improved in some segments (P <.05) during LV and BiV pacing. A homogenization of segmental contractions was observed during LV and BiV pacing as evaluated by net systolic displacement and segmental myocardial performance index. LV and BiV pacing provides benefits that can be quantified by echocardiography.
Cleveland Clinic Foundation and Medtronic, Inc., Minneapolis, MN, USA.
Jing Ping
JP
Sun
Edward
E
Chinchoy
Erwan
E
Donal
Zoran B
ZB
Popović
George
G
Perlic
Craig R
CR
Asher
Neil L
NL
Greenberg
Richard A
RA
Grimm
Bruce L
BL
Wilkoff
James D
JD
Thomas
D000704:Analysis of Variance; D001783:Blood Flow Velocity; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*