Tissue Doppler imaging and strain Doppler imaging as modalities for predicting clinical improvement in patients receiving biventricular pacing.
BACKGROUND
The purpose of this study was to determine the utility and efficacy of tissue Doppler imaging (TDI) and strain Doppler imaging (SDI) for evaluating ventricular synchrony and function, and for predicting the long-term clinical improvement in patients undergoing biventricular pacing (BVP).


RESULTS
TDI and SDI were performed before and <1 month after initiating BVP in 17 patients with advanced heart failure. An intraventricular conduction delay between the left ventricular (LV) septal and lateral walls was measured by TDI. The average LV strain (LV-strain) was calculated from data obtained at the center of 6 regions of the LV (base and mid-point between the basal and apical portions, and the mid-point between these 2 points on the septal and lateral walls). During a 23+/-7 month follow-up period, 12 patients improved clinically and did not require re-hospitalization for heart failure (responder group), but the remaining 5 did not improve (nonresponder group). Before BVP, the intraventricular conduction delay was greater in the responder group than in the nonresponder group (p<0.01), but after BVP, it did not differ between the 2 groups. LV-strain improved after BVP in the responder group but not in the nonresponder group (p<0.05).


CONCLUSIONS
A high intraventricular conduction delay before BVP and decreased strain shortly after BVP may predict long-term clinical improvement in patients undergoing this treatment.
Tada
Hiroshi
H
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. tada.h@cvc.pref.gunma.jp
Toide
Hiroyuki
H
Naito
Shigeto
S
Kurosaki
Kenji
K
Ito
Sachiko
S
Miyaji
Kohei
K
Yamada
Minoru
M
Okaniwa
Hiroki
H
Kobayashi
Yasuyuki
Y
Maruyama
Hiroko
H
Higuchi
Rumi
R
Nogami
Akihiko
A
Oshima
Shigeru
S
Taniguchi
Koichi
K
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006329:Heart Conduction System; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D016277:Ventricular Function, Left