title: Association between presystolic ventricular flash and left ventricular functional recovery after cardiac resynchronization therapy.
abstract: The presence of septal flash (SF), an early inward/outward motion of the ventricular septum, has been reported to predict a fair response to cardiac resynchronization therapy (CRT) in patients with heart failure. Using speckle tracking echocardiography, we investigated whether the extent of pre-CRT SF was associated with left ventricular (LV) functional recovery after CRT device implantation. Fifteen patients with left bundle branch block with a mean LV ejection fraction of 23 ± 9% were enrolled in this study. The extent of presystolic ventricular flash (PSVF), which was defined if there was a peak in the radial strain curve in the preejection period, was semiquantified by counting the number of PSVF-positive segments. Patients underwent radial strain analysis before and between 3 and 6 months after CRT. After CRT device implantation, LV end-diastolic and end-systolic volumes were decreased, LV ejection fraction was increased, and LV filling time corrected by RR interval was increased. The number of PSVF-positive segments at baseline showed a graded association with improvement in both LV ejection fraction and LV filling time. In conclusion, the finding that a larger number of PSVF-positive segments before CRT predicted fair LV functional recovery after CRT suggests that PSVF may represent a substrate that is amenable to functional response to CRT.
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Ito
authors.forename: Shun
authors.initials: S
authors.lastname: Kizawa
authors.forename: Shimpei
authors.initials: S
authors.lastname: Nogi
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Shimamoto
authors.forename: Kaori
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000517:prevention & control*
keywords: cardiac pacing; heart failure; strain