Comparison of myocardial deformation and velocity dyssynchrony for identification of responders to cardiac resynchronization therapy.
OBJECTIVE
It is unclear whether myocardial velocity or deformation indices of dyssynchrony are better at predicting response to cardiac resynchronization therapy (CRT). Therefore, two indices of left ventricular (LV) dyssynchrony based on myocardial velocity and deformation were compared to predict success of CRT.


RESULTS
Sixty patients with dilated cardiomyopathy, New York Heart Association class III-IV, LV ejection fraction (EF) < or =35%, QRS >120 ms underwent CRT. The standard deviation of the averaged time-to-peak longitudinal negative strain (Tepsilon-SD) and positive systolic velocity (Tv-SD) of 12 LV segments were calculated before and after 6 months of CRT. Responders were defined at month 6 by > or =20% EF increase and/or > or =15% end-systolic volume (ESV) decrease with respect to baseline. On univariable analysis, baseline Tepsilon-SD and Tv-SD were both significantly associated with CRT response; however, the area under the receiver operating characteristic curve was better for Tepsilon-SD. On bivariable analysis, only Tepsilon-SD retained an independent prognostic value for CRT response. Results of the analysis did not change when the logistic models were adjusted for aetiology.


CONCLUSIONS
Baseline dyssynchrony of longitudinal myocardial peak deformation (Tepsilon-SD) appears to be better than dyssynchrony of longitudinal myocardial peak systolic velocities (Tv-SD) for the identification of CRT responders.
Mele
Donato
D
Azienda Ospedaliero-Universitaria, Ferrara and Fondazione Salvatore Maugeri, Brescia, Corso Giovecca 203, 44100 Ferrara, Italy. donatomele@libero.it
Toselli
Tiziano
T
Capasso
Fabio
F
Stabile
Giuseppe
G
Piacenti
Marcello
M
Piepoli
Massimo
M
Giatti
Sara
S
Klersy
Catherine
C
Sallusti
Luciano
L
Ferrari
Roberto
R
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002306:Cardiac Volume / Q000502:physiology*; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology*; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D013599:Systole; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left / Q000502:physiology*