Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct;7(5):813-22.
doi: 10.5114/aoms.2011.25556. Epub 2011 Nov 8.

Baseline tissue Doppler imaging-derived echocardiographic parameters and left ventricle reverse remodelling following cardiac resynchronization therapy introduction

Jerzy Wiliński  1 , Danuta Czarnecka, Wiktoria Wojciechowska, Małgorzata Kloch-Badełek, Marek Jastrzębski, Bogumiła Bacior, Tomasz Sondej, Aleksander Kusiak
Affiliations

Baseline tissue Doppler imaging-derived echocardiographic parameters and left ventricle reverse remodelling following cardiac resynchronization therapy introduction

Jerzy Wiliński et al. Arch Med Sci. 2011 Oct.

Abstract

Introduction: The aim of the study was to assess the relation of baseline mechanical dyssynchrony with the left ventricular end-systolic volume (LVESV) decrease following cardiac resynchronization (CRT) therapy introduction.

Material and methods: Sixty consecutive patients (aged 66.3 ± 8.7 years; 57 men) with chronic heart failure (71.7% of ischaemic and 28.3% of non-ischaemic origin) and current indications for CRT were assessed before and 3 months after biventricular heart stimulator implantation. Longitudinal movements of twelve segments of the left ventricle (LV) (6 basal and 6 midlevel) and two segments of the right ventricle (RV) were analysed using tissue Doppler imaging (TDI) techniques with time from onset of Q wave in ECG to peak systolic velocity in colour-coded TDI (T(TDI)), time to peak strain (T(strain)) and time to peak strain rate (T(strain) (rate)). Minimal and maximal time differences within LV and between LV and RV walls were calculated.

Results: In the study group LVEF and 6-min walk test distance increased, while NYHA class, NT-proBNP level, left ventricular end-diastolic volume and LVESV decreased. Significant correlations between the magnitude of LVESV reduction with maximal time differences between T(strain) of 12 LV segments (r=0.34, p = 0.017) and time differences between T(TDI) basal LV-RV segments (r = -0.29, p=0.041) were found.

Conclusions: Only a few TDI-derived parameters such as maximal time differences between T(strain) of 12 LV segments and T(TDI) difference of LV-RV basal segments can be useful to predict the magnitude of left ventricle reverse remodelling after CRT introduction.

Keywords: Doppler dyssynchrony; echocardiography; heart failure; pacemakers.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Correlation between the magnitude of LVESV reduction following CRT introduction and initial parameters of mechanical dyssynchrony: A– TTDI basal LV-RV segments, B– Tstrain of 12 LV segments TTDI basal LV-RV segments – maximum difference of time from the beginning of QRS complex to maximum systolic velocity between basal left ventricle and right ventricle segments, Tstrain-12 – maximum difference of time from the beginning of QRS complex to maximum systolic strain among 12 left ventricle segments
See this image and copyright information in PMC

References

    1. Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure : the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur J Heart Fail. 2008;10:933–89. - PubMed
    1. Dickstein K, Vardas PE, Auricchio A, et al. focused update of ESC Guidelines on device therapy in heart failure: an update of the 2008 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC Guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Eur J Heart Fail. 2010;12:1143–53. - PubMed
    1. Adamson PB, Kleckner KJ, VanHout WL, Srinivasan S, Abraham WT. Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure. Circulation. 2003;108:266–9. - PubMed
    1. Lappegard KT, Bjornstad H. Anti-inflammatory effect of cardiac resynchronization therapy. Pacing Clin Electrophysiol. 2006;29:753–8. - PubMed
    1. Sarzi Braga S, La Rovere M, Pedretti R. Baroreflex sensitivity normalization after cardiac resynchronization therapy (Case report) Int J Cardiol. 2006;109:118–20. - PubMed