What question did this study set out to answer?

To assess the acute physiological effects of cardiac resynchronization therapy on left ventricular synchrony and performance using noninvasive echocardiographic indices.

December 1, 2002Journal of Cardiovascular Electrophysiology

Noninvasive Assessment of Cardiac Resynchronization Therapy for Congestive Heart Failure Using Myocardial Strain and Left Ventricular Peak Power as Parameters of Myocardial Synchrony and Function

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Why the study?

Does cardiac resynchronization therapy improve left ventricular synchrony and function as measured by noninvasive echocardiographic parameters in patients with heart failure?

Population

22 patients enrolled in the InSync trial with congestive heart failure, ejection fraction < 35%, and QRS >…

Comparison

Cardiac resynchronization therapy by… vs Ventricular pacing inhibited

Design

Cross-sectional

Follow-up

1 to 12 months post-implantation (acute assessment)

Authors

ZPZoran PopovićNorthwestern University RGRichard A. GrimmCardiac Imaging GPGeorge PerlicMedtronic (United States)

Discussion

Member takes

Implication

Acute pacing-linked LV gains may inform CRT assessment; leaves open need for randomized validation of these indices.

Key Points

To assess the acute physiological effects of cardiac resynchronization therapy on left ventricular synchrony and performance using noninvasive echocardiographic indices.
Evaluated 22 heart failure patients enrolled in the InSync trial (mean age 64 ± 9 years; ejection fraction < 35%, QRS > 130 ms) at 1 to 12 months after pacemaker implantation during active and inhibited pacing.
Measured regional myocardial strain across the interventricular septum and ventricular free walls using color Doppler tissue echocardiography.
Calculated the peak power index, Z ratio, and Tei index from noninvasive arterial blood pressure and pulse-wave Doppler recordings of the left ventricular outflow tract.
Active biventricular pacing significantly improved regional myocardial strain (P = 0.01) and decreased the left ventricular strain coefficient of variation from 2.7 ± 2.4 to 1.3 ± 0.7 (P = 0.009).
Left ventricular peak power index increased from 84 ± 24 to 94 ± 27 cm × mmHg/sec during active pacing (P = 0.004).
Global cardiac performance improved with pacing, evidenced by an increase in the Z ratio from 0.71 ± 0.08 to 0.78 ± 0.07 (P = 0.0005) and a reduction in the Tei index from 0.86 ± 0.33 to 0.59 ± 0.16 (P = 0.0002).

Structured PICO

Does cardiac resynchronization therapy improve left ventricular synchrony and function as measured by noninvasive echocardiographic parameters in patients with heart failure?

Population

22 patients enrolled in the InSync trial with congestive heart failure, ejection fraction < 35%, and QRS > 130 msec, mean age 64 +/- 9 years, 18 men and 4 women.

Intervention

Cardiac resynchronization therapy by biventricular pacing (assessed during active pacing)

Comparator

Ventricular pacing inhibited (assessed while pacing was turned off)

Outcome

Regional myocardial strains, peak power index, Z ratio, and tei indexsurrogate

Cardiac resynchronization therapy acutely improves left ventricular performance and synchrony as measured by noninvasive echocardiographic indices.

Cite This Study

Popović et al. (2002) studied this question.

synapsesocial.com/papers/6a6fc657b5c1fe5ca9dfa15d https://doi.org/10.1046/j.1540-8167.2002.01203.x

Topics

Heart failure HFrEF treatment

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Noninvasive Assessment of Cardiac Resynchronization Therapy for Congestive Heart Failure Using Myocardial Strain and Left Ventricular Peak Power as Parameters of Myocardial Synchrony and Function

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Noninvasive Assessment of Cardiac Resynchronization Therapy for Congestive Heart Failure Using Myocardial Strain and Left Ventricular Peak Power as Parameters of Myocardial Synchrony and Function

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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