title: Evaluation of longitudinal and radial two-dimensional strain imaging versus Doppler tissue echocardiography in predicting long-term response to cardiac resynchronization therapy.
abstract: BACKGROUND
  Cardiac resynchronization therapy (CRT) leads to hemodynamic and clinical improvement in patients with heart failure. This study compares the new technique of 2-dimensional (2D) strain imaging with Doppler tissue imaging (DTI) in the prediction of the long-term response to CRT.
  
  
  METHODS
  In all, 38 patients with heart failure (New York Heart Association II-III, QRS > 120 milliseconds, left ventricular ejection fraction < 0.35) received CRT and echocardiographic evaluation with a mean follow-up of 9.4 months.
  
  
  RESULTS
  Of the patients, 47.4% were hemodynamic responders to long-term CRT. In the responder group, the maximum delay in the longitudinal and radial 2D strain in the basal segments and the maximum delay in the DTI peak systolic myocardial velocities but not DTI strain decreased. In receiver operating characteristic analysis, the baseline delay of DTI peak velocities predicts improvement after CRT, whereas baseline 2D- and DTI-strain measurements fail to predict a long-term response to CRT.
  
  
  CONCLUSIONS
  Although there is a significant decrease in longitudinal and radial 2D strain-derived delays after CRT, the resulting predictive value is not superior to DTI.
authors.affiliation: Universitätsmedizin Berlin, Medical Clinic for Cardiology and Angiology, Charité Campus Mitte, Berlin, Germany. fabian.knebel@charite.de <fabian.knebel@charite.de>
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schattke
authors.forename: Hansjürgen
authors.initials: H
authors.lastname: Bondke
authors.forename: Torsten
authors.initials: T
authors.lastname: Walde
authors.forename: Stephan
authors.initials: S
authors.lastname: Eddicks
authors.forename: Rona
authors.initials: R
authors.lastname: Reibis
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology