Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block
Key result
CRT reverses the baseline septal-lateral difference in mid-segmental peak strain.
- P<0.05
- n=18
Why the study?
Does cardiac resynchronization therapy improve regional myocardial strain distribution in patients with symptomatic systolic heart failure and LBBB?
Population
18 patients with symptomatic systolic heart failure and left bundle branch block, mean age 65 +/- 11 years…
Comparison
Cardiac resynchronization therapy (CRT) vs Baseline (before CRT)
Design
Cohort
Authors
Discussion
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Implication
Cardiac resynchronization therapy reverses the abnormal myocardial fiber strain distribution seen in patients with systolic heart failure and LBBB, suggesting strain imaging could aid in patient selection.
Key Points
- To assess whether cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients presenting with heart failure and left bundle branch block.
- Evaluated left ventricular myocardial strain patterns in patients with heart failure and left bundle branch block receiving cardiac resynchronization therapy.
- Assessed regional myocardial deformation and mechanical synchrony across cardiac segments before and following device therapy.
- Cardiac resynchronization therapy reversed abnormal regional myocardial strain distribution across the left ventricle.
- Correction of electrical dyssynchrony restored balanced mechanical contraction between opposing ventricular walls.
Study Design
Type
Observational (n=18)
Structured PICO
Does cardiac resynchronization therapy improve regional myocardial strain distribution in patients with symptomatic systolic heart failure and LBBB?
P
Population
18 patients (mean age 65 years, 33.3% female) with symptomatic systolic heart failure and left bundle branch block evaluated before and after CRT.
E
Exposure
Cardiac resynchronization therapy (CRT)
C
Comparator
Baseline (before CRT)
O
Outcome
Regional myocardial strain distribution (regional longitudinal systolic velocity, systolic strain rate, and systolic strain from the basal and mid-segments of the septum and lateral wall)surrogate
Main Result
p-value: p=<0.05
Cardiac resynchronization therapy reverses the abnormal myocardial fiber strain distribution seen in patients with systolic heart failure and LBBB, suggesting strain imaging could aid in patient selection.
Cite This Study
Breithardt et al. (2003) conducted an observational in symptomatic systolic heart failure and left bundle branch block (n=18). Cardiac resynchronization therapy (CRT) vs. Before CRT (baseline) was evaluated on septal-lateral difference in mid-segmental peak strain (p=<0.05). Cardiac resynchronization therapy reversed the septal-lateral difference in mid-segmental peak strain from -46 ms at baseline to 17 ms during therapy (p<0.05).