The effect of cardiac resynchronization therapy on left ventricular diastolic function assessed with speckle-tracking echocardiography

Shanks, Miriam, Antoni, M. Louisa, Hoke, Ulas, Bertini, Matteo, Ng, Arnold C.T., Auger, Dominique, Marsan, Nina Ajmone, van Erven, Lieselot, Holman, Eduard R., Schalij, Martin J., Bax, Jeroen J. and Delgado, Victoria (2011) The effect of cardiac resynchronization therapy on left ventricular diastolic function assessed with speckle-tracking echocardiography. European Journal of Heart Failure, 13 10: 1133-1139. doi:10.1093/eurjhf/hfr115


Author Shanks, Miriam
Antoni, M. Louisa
Hoke, Ulas
Bertini, Matteo
Ng, Arnold C.T.
Auger, Dominique
Marsan, Nina Ajmone
van Erven, Lieselot
Holman, Eduard R.
Schalij, Martin J.
Bax, Jeroen J.
Delgado, Victoria
Title The effect of cardiac resynchronization therapy on left ventricular diastolic function assessed with speckle-tracking echocardiography
Journal name European Journal of Heart Failure   Check publisher's open access policy
ISSN 1388-9842
1879-0844
Publication date 2011-10-01
Sub-type Article (original research)
DOI 10.1093/eurjhf/hfr115
Volume 13
Issue 10
Start page 1133
End page 1139
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2012
Language eng
Formatted abstract
Aims Changes in left ventricular (LV) diastolic function after cardiac resynchronization therapy (CRT) in relation to LV reverse remodelling and heart failure aetiology have not been extensively characterized. The aims of the study were to evaluate changes in LV diastolic function with speckle-tracking echocardiography in relation to: (i) cardiac resynchronization therapy response (LV remodelling) and (ii) heart failure aetiology.
Methods and results A total of 192 heart failure patients undergoing CRT implantation were evaluated. Speckle-tracking echocardiography was performed before and 6 months after implantation and reliable analysis was obtained in 188 patients. Left ventricular diastolic function was assessed by measuring diastolic strain rate during the isovolumic relaxation period (SRIVR) and by calculating the ratio of peak transmitral E-wave to SRIVR (E/SRIVR). Changes in LV diastolic parameters were evaluated in responders and non-responders and in patients with ischaemic and non-ischaemic cardiomyopathy. Response to CRT was defined as ≥15% reduction in LV end-systolic volume at 6 months follow-up. One-hundred and nine patients (58%) were defined as responders. Significant improvements in LV diastolic performance were observed in responders with improvement in SRIVR (from 0.14 ± 0.08 to 0.18 ± 0.12 s−1, P= 0.001) and E/SRIVR (from 834 ± 840 to 641 ± 612, P= 0.04). In addition, LV relaxation improved in patients with non-ischaemic aetiology (SRIVR: from 0.15 ± 0.08 to 0.19 ± 0.13 s−1, P= 0.004). In contrast, LV relaxation did not improve in non-responders and in patients with ischaemic heart disease.
Conclusions Novel diastolic strain rate indices are useful for evaluating changes in LV diastolic function after CRT. Improvement in diastolic function was only observed in responders to CRT and patients with non-ischaemic aetiology.
Keyword Cardiac resynchronization therapy
Diastolic function
Speckle-tracking echocardiography
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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