title: Low value of simple echocardiographic indices of ventricular dyssynchrony in predicting the response to cardiac resynchronization therapy.
abstract: OBJECTIVE
  A recent study suggested that no single echocardiographic index of cardiac dyssynchrony can reliably identify candidates for cardiac resynchronization therapy (CRT). We examined the value of three simple echocardiographic indices for predicting the 6-month clinical and echocardiographic responses to CRT.
  
  
  RESULTS
  We analysed data from 75 CRT-D system recipients. Standard echocardiography was used to measure aortic pre-ejection delay (APED), interventricular mechanical delay (IVMD), and delayed activation of the left ventricular (LV) infero-lateral wall (OVERLAP). Clinical responders were defined as patients who had an improved status, based on rehospitalization for heart failure, NYHA class, and peak oxygen consumption. Echocardiographic responders had a > or =10% decrease in LV end-systolic volume. During the study, one patient died and five were lost to follow-up. Of the remaining 69 analysable patients, 50 (72.5%) were classed as clinical responders and 41 (59.4%) as echocardiographic responders to CRT. Before CRT implantation, APED, IVMD, and OVERLAP were similar in responders and non-responders. The value of these indices of dyssynchrony as single or combined predictors of the clinical or echocardiographic response to CRT was low, with sensitivities ranging between 4 and 63%, and specificities between 37 and 100%.
  
  
  CONCLUSIONS
  Simple echocardiographic indices of dyssynchrony were poor predictors of response to CRT.
authors.affiliation: Hospital Haut Leveque, Pessac, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lafitte
authors.forename: Patricia
authors.initials: P
authors.lastname: Réant
authors.forename: Sylvain
authors.initials: S
authors.lastname: Reuter
authors.forename: Jacques
authors.initials: J
authors.lastname: Clementy
authors.forename: Ralph-Uwe
authors.initials: RU
authors.lastname: Mletzko
authors.forename: Robert M
authors.initials: RM
authors.lastname: Siegel
authors.forename: Kinga
authors.initials: K
authors.lastname: Goscinska-Bis
authors.forename: Robert
authors.initials: R
authors.lastname: Bowes
authors.forename: John
authors.initials: J
authors.lastname: Morgan
authors.forename: Sandrine
authors.initials: S
authors.lastname: Bénard
authors.forename: Christophe
authors.initials: C
authors.lastname: Leclercq
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D004311:Double-Blind Method; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000628:therapy