Key result
Baseline delay of circumferential 2D strain did not predict long-term response to cardiac resynchronization therapy.
Why the study?
Does baseline circumferential 2D-strain imaging predict long-term hemodynamic response to cardiac resynchronization therapy in heart failure patients?
Cohort (n=38)
No
Does baseline circumferential 2D-strain imaging predict long-term hemodynamic response to cardiac resynchronization therapy in heart failure patients?
While circumferential 2D-strain delays decrease significantly after CRT, indicating improved 3D myocardial contraction, baseline circumferential strain delay does not significantly predict long-term hemodynamic response better than established echocardiographic parameters.
Answers are grounded in this paper and cite their sources.
Does not support baseline circumferential 2D strain delay for CRT response prediction; leaves open whether strain parameters add value beyond standard echocardiography.
BACKGROUND: Cardiac Resynchronization Therapy (CRT) leads to hemodynamic and clinical improvement in heart failure patients. The established methods to evaluate myocardial asynchrony analyze longitudinal and radial myocardial function. This study evaluates the new method of circumferential 2D-strain imaging in the prediction of the long-term response to CRT. METHODS AND RESULTS: 38 heart failure patients (NYHA II-III, QRS > 120 ms, LVEF < 0.35) received CRT and echocardiographic evaluation with a mean follow-up of 9.4 months. 18 (47.4%) of the patients were hemodynamic responders to long-term CRT. In the responder group, the maximum delay in the circumferential 2D-strain in the basal segments decreased (246 +/- 94 to 123 +/- 92 ms, p < 0.001). In the non-responder group there was no significant change (pre CRT: 195 +/- 86, post CRT 135 +/- 136 ms, p = 0.84). This was paralleled by a reduction of the maximum delay in the radial and longitudinal 2D strain in the basal segments. In ROC analysis, the baseline delay of circumferential 2D strain (AUC 0.66 (+/- 0.14)) does not predict a long-term response to CRT (p = 0.37). CONCLUSION: There is a significant decrease in the circumferential 2D-strain derived delays after CRT, indicating that resynchronization induces improvement in all three dimensions of myocardial contraction. However, the resulting predictive values of 2D strain delays are not superior to longitudinal and radial 2D-strain or TDI delays.
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Knebel et al. (2008) conducted a cohort in Heart Failure (n=38). Cardiac Resynchronization Therapy (CRT) vs. Non-responders was evaluated on Prediction of long-term response to CRT using baseline maximum delay of circumferential 2D strain (AUC 0.66, p=0.37). Baseline delay of circumferential 2D strain did not predict long-term response to cardiac resynchronization therapy.
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