Key result
A higher radial global dyssynchrony index independently predicted left ventricular reverse remodeling 6 months after cardiac resynchronization therapy.
Why the study?
Does the radial global dyssynchrony index measured by 2D strain echocardiography predict left ventricular reverse remodeling in patients receiving cardiac resynchronization therapy?
Observational (n=62)
Does the radial global dyssynchrony index measured by 2D strain echocardiography predict left ventricular reverse remodeling in patients receiving cardiac resynchronization therapy?
A radial global dyssynchrony index >0.47 measured by 2D strain echocardiography strongly predicts left ventricular reverse remodeling 6 months after cardiac resynchronization therapy.
Answers are grounded in this paper and cite their sources.
Radial dyssynchrony index may predict CRT response; extends strain predictors but leaves open prospective validation.
BACKGROUND: Cardiac mechanical efficiency requires that opposing left ventricular regions are coupled both in shortening and lengthening during the same phase of cardiac cycle. Aim of this study was to evaluate whether global measures of mechanical dyssynchrony are able to predict reverse remodeling of the left ventricle in patients receiving cardiac resynchronization therapy (CRT). METHODS: Sixty-two patients underwent a clinical examination, including New York Heart Association class evaluation and 6-minute walking distance and both echocardiographic study before and 6 months after CRT. Intraventricular dyssynchrony was evaluated by two-dimensional strain echocardiography, measuring the amount of uncoordinated contraction and relaxation between septum and free wall for both longitudinal and radial function and was presented as the longitudinal global dyssynchrony index (LGDI) and the radial global dyssynchrony index (RGDI). Reverse remodeling was defined by a left ventricular end systolic volume reduction >or= 15%. RESULTS: After CRT 39 patients showed reverse remodeling. In this group, RGDI (0.74 +/- 0.26 vs 0.32 +/- 0.30; P = 0.0001) and LGDI (0.52 +/- 0.28 vs 0.30 +/- 0.24; P = 0.002) were significantly higher than in nonresponders. A receiver-operating characteristic curve analysis showed that RGDI >0.47 and LGDI >0.34 had a sensitivity and a specificity to predict reverse remodeling of 87% and 74%, 82%, and 74%, respectively. Stepwise forward multiple logistic regression analysis showed that RGDI (O.R.:13.4; 95%C.I.:4.2-120.5; P < 0.0001) was an independent determinant of a positive response to CRT. CONCLUSION: A radial global dyssynchrony index predicts left ventricular reverse remodeling after CRT.
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Ascione et al. (2008) conducted an observational in Heart failure requiring cardiac resynchronization therapy (n=62). Radial global dyssynchrony index (RGDI) was evaluated on Left ventricular reverse remodeling (left ventricular end systolic volume reduction ≥ 15%) (OR 13.4, 95% CI 4.2-120.5, p=< 0.0001). A higher radial global dyssynchrony index independently predicted left ventricular reverse remodeling 6 months after cardiac resynchronization therapy.
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