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Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy

BACKGROUND: In patients with left ventricular (LV) dysssynchrony, contraction that doesn’t fall into ejection period (LVEj) results in a waste of energy due to inappropriate contraction timing, which was now widely treated by cardiac resynchronization therapy(CRT). Myocardial Contraction Efficiency...

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Autores principales: Fulati, Zibire, Liu, Yang, Sun, Ning, Kang, Yu, Su, Yangang, Chen, Haiyan, Shu, Xianhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245808/
https://www.ncbi.nlm.nih.gov/pubmed/30453975
http://dx.doi.org/10.1186/s12947-018-0148-5
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author Fulati, Zibire
Liu, Yang
Sun, Ning
Kang, Yu
Su, Yangang
Chen, Haiyan
Shu, Xianhong
author_facet Fulati, Zibire
Liu, Yang
Sun, Ning
Kang, Yu
Su, Yangang
Chen, Haiyan
Shu, Xianhong
author_sort Fulati, Zibire
collection PubMed
description BACKGROUND: In patients with left ventricular (LV) dysssynchrony, contraction that doesn’t fall into ejection period (LVEj) results in a waste of energy due to inappropriate contraction timing, which was now widely treated by cardiac resynchronization therapy(CRT). Myocardial Contraction Efficiency was defined as the ratio of Efficient Contraction Time (ECTR) and amplitude of efficient contraction (ECR) during LVEj against that in the entire cardiac cycle. This study prospectively investigated whether efficiency indexes could predict CRT outcome. METHODS: Our prospective pilot study including 70 CRT candidates, parameters of myocardial contraction timing and contractility were measured by speckle tracking echocardiography (STE) and efficiency indexes were calculated accordingly at baseline and at 6-month follow-up. Primary outcome events were predefined as death or HF hospitalization, and secondary outcome events were defined as all-cause death during the follow-up. 16-segement Standard deviation of time to onset strain (TTO-16SD) and time to peak strain (TTP-16SD) were included as the dyssynchrony indexes. RESULTS: According to LV end systolic volume (LVESV) and LV eject fraction(LVEF) values at 6-month follow-up, subjects were classified into responder and non-responder groups, ECR (OR 0.87, 95%CI 0.78–0.97, P < 0.05) and maximum longitudinal strain (MLS) (OR 2.22, 95%CI 1.36–3.61, P < 0.01) were the two independent predictors for CRT response, Both TTO-16SD and TTP-16SD failed to predict outcome. Patients with poorer myocardial contraction efficiency and better contractility are more likely to benefit from CRT. CONCLUSIONS: STE can evaluate left ventricular contraction efficiency and contractility to predict CRT response. When analyzing myocardial strain by STE, contraction during LVEj should be highlighted.
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spelling pubmed-62458082018-11-26 Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy Fulati, Zibire Liu, Yang Sun, Ning Kang, Yu Su, Yangang Chen, Haiyan Shu, Xianhong Cardiovasc Ultrasound Research BACKGROUND: In patients with left ventricular (LV) dysssynchrony, contraction that doesn’t fall into ejection period (LVEj) results in a waste of energy due to inappropriate contraction timing, which was now widely treated by cardiac resynchronization therapy(CRT). Myocardial Contraction Efficiency was defined as the ratio of Efficient Contraction Time (ECTR) and amplitude of efficient contraction (ECR) during LVEj against that in the entire cardiac cycle. This study prospectively investigated whether efficiency indexes could predict CRT outcome. METHODS: Our prospective pilot study including 70 CRT candidates, parameters of myocardial contraction timing and contractility were measured by speckle tracking echocardiography (STE) and efficiency indexes were calculated accordingly at baseline and at 6-month follow-up. Primary outcome events were predefined as death or HF hospitalization, and secondary outcome events were defined as all-cause death during the follow-up. 16-segement Standard deviation of time to onset strain (TTO-16SD) and time to peak strain (TTP-16SD) were included as the dyssynchrony indexes. RESULTS: According to LV end systolic volume (LVESV) and LV eject fraction(LVEF) values at 6-month follow-up, subjects were classified into responder and non-responder groups, ECR (OR 0.87, 95%CI 0.78–0.97, P < 0.05) and maximum longitudinal strain (MLS) (OR 2.22, 95%CI 1.36–3.61, P < 0.01) were the two independent predictors for CRT response, Both TTO-16SD and TTP-16SD failed to predict outcome. Patients with poorer myocardial contraction efficiency and better contractility are more likely to benefit from CRT. CONCLUSIONS: STE can evaluate left ventricular contraction efficiency and contractility to predict CRT response. When analyzing myocardial strain by STE, contraction during LVEj should be highlighted. BioMed Central 2018-11-19 /pmc/articles/PMC6245808/ /pubmed/30453975 http://dx.doi.org/10.1186/s12947-018-0148-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Fulati, Zibire
Liu, Yang
Sun, Ning
Kang, Yu
Su, Yangang
Chen, Haiyan
Shu, Xianhong
Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
title Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
title_full Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
title_fullStr Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
title_full_unstemmed Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
title_short Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
title_sort speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245808/
https://www.ncbi.nlm.nih.gov/pubmed/30453975
http://dx.doi.org/10.1186/s12947-018-0148-5
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