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

• Published in: Cardiovascular ultrasound 2018-11, Vol.16 (1), p.30-30, Article 30
• Main Authors: Fulati, Zibire, Liu, Yang, Sun, Ning, Kang, Yu, Su, Yangang, Chen, Haiyan, Shu, Xianhong
• Format: Article
• Language: English
• Subjects: Adult; Beta blockers; Cardiac resynchronization therapy; Cardiac Resynchronization Therapy - methods; Cohort Studies; Computing time; Contraction efficiency; Echocardiography; Echocardiography - methods; Efficiency; Electrocardiography; Female; Heart; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Heart Failure - therapy; Heart function; Humans; Image Interpretation, Computer-Assisted; Logistic Models; Male; Middle Aged; Muscle contraction; Myocardial Contraction - physiology; Observer Variation; Odds Ratio; Patients; Pilot Projects; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Severity of Illness Index; Speckle tracking echocardiography; Strain; Strain analysis; Studies; Therapy; Tracking; Treatment Outcome; Ventricle
• ISSN: 1476-7120; 1476-7120
• DOI: 10.1186/s12947-018-0148-5

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. 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. 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