title: Maximum ventricular dyssynchrony predicts clinical improvement and reverse remodeling during cardiac resynchronization therapy.
abstract: BACKGROUND
  Tissue synchronization imaging (TSI) and tissue tracking imaging (TTI) might facilitate the evaluation of ventricular dyssynchrony.
  
  
  METHODS
  In 22 patients, TSI and TTI were performed before and < 1 month after onset of cardiac resynchronization therapy (CRT). With TSI guidance, maximum left ventricular (LV) intraventricular conduction delay (IVCDmax) was the greatest difference in time-to-peak velocity between septum and lateral wall. IVCD between the basal septum and lateral wall (IVCDbase) was also measured. Using TTI, the mean peak myocardial displacement of the basal septal and lateral walls (PMDbase), and the temporal coefficient of variation of the PMD in six LV regions (CV-PMDLV) were measured. The patients were divided into responders (whose LV end-systolic volume decreased by >/= 15% during a 27 +/- 9 months follow-up) and nonresponders.
  
  
  RESULTS
  Before CRT, IVCDbase was similar in both groups, and remained unchanged within the 1st month of CRT in both groups. However, before CRT, IVCDmax was greater in responders than in nonresponders (P < 0.05), and decreased only in the responders during CRT (P < 0.05). No significant difference was observed in PMDbase or CV-PMDLV between the two groups, before or during CRT.
  
  
  CONCLUSIONS
  TSI was useful to measure IVCDmax. A greater IVCDmax before CRT that decreased shortly after onset of CRT may predict long-term clinical improvement in CRT recipients.
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. tada.h@cvc.pref.gunma.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Toide
authors.forename: Hiroki
authors.initials: H
authors.lastname: Okaniwa
authors.forename: Rumi
authors.initials: R
authors.lastname: Higuchi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakajima
authors.forename: Rika
authors.initials: R
authors.lastname: Utsugi
authors.forename: Tohru
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Miyaji
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaseno
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Tadokoro
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nogami
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Taniguchi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D020257:Ventricular Remodeling