scholarly journals Global longitudinal strain at baseline is a marker of ventricular arrhythmias in patients with cardiac resynchronization therapy

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. 2718-2718
Author(s):  
N. Hasselberg ◽  
A. Brunet ◽  
K. H. Haugaa ◽  
E. Kongsgaard ◽  
E. Donal ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Ventricular Arrhythmias ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy

Abstract 14303: Low Global Longitudinal Strain in Ischemic Cardiomyopathy Patients at Baseline is Associated With Ventricular Arrhythmias After Cardiac Resynchronization Therapy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Bhupendar Tayal ◽  
Antonia Delgado-Montero ◽  
Akiko Goda ◽  
Samir Saba ◽  
Niels Risum ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Ventricular Arrhythmias ◽  
Ischemic Cardiomyopathy ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Increased Risk ◽  
Prognostic Implications

Introduction: Heart failure (HF) patients have an increased risk for ventricular arrhythmias (VA) and in particular patients with ischemic cardiomyopathy (ICM) have a worse prognosis after cardiac resynchronization therapy with defibrillator (CRT-D) compared with non-ischemic patients. Hypothesis: We hypothesize that global longitudinal strain (GLS) at baseline has the ability to identify ICM patients at higher risk for VA after CRT-D. Methods: We prospectively studied 175 consecutive HF patients implanted with CRT-D from a single center. All of them had class II-IV HF symptoms, LV ejection fraction (≤35%), QRS≥120 ms. GLS was measured from the three standard apical views and presented as absolute values. Outcome event was defined as VA (anti-tachycardia pacing or appropriate shock) after CRT in the first 2 years of follow-up. Results: Of 175 patients aged 65±11 years, 135 (77%) were male and 115 (66%) had ICM. They suffered 34 (19%) VA events over 2 years. Mean GLS of the population was 8.1±3.0. GLS (< 6.5%) was associated with VA events after CRT-D with a sensitivity of 70% and specificity of 56%. A cutoff of GLS<6.5% was associated with greater VA events in the ICM patients with HR 2.92 (95% confidence interval 1.48 to 5.77, p=0.002). A similar significant association of GLS was not seen in the non ICM patients (p=0.12). Conclusions: Low GLS (<6.5% in absolute values) in ICM patients is associated with increased risk for VA after CRT-D and might represent more extensive myocardial scarring and has prognostic implications.

Abstract 2819: Identification and Characterization of Super-Responders to Cardiac Resynchronization Therapy: An Echocardiographic Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Amira Zaroui ◽  
Patricia Reant ◽  
Erwan Donal ◽  
Aude Mignot ◽  
Pierre Bordachar ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Lv Function ◽  
Resynchronization Therapy ◽  
Systolic Volume ◽  
End Systolic Volume

In some patients, cardiac resynchronization therapy (CRT) has been recently shown to induce a spectacular effect on left ventricular (LV) function and inverted remodeling with nearby normalization of LV contraction. Objectives: To analyze and characterize super-responders (CRTSR) by echocardiography before CRT. 186 patients have been investigated before and 6 months after implantation of a CRT device with conventional indication according to ESC guidelines. Echocardiographies including measurements of LV dimensions, and contraction by 2-dimensional strain, and pressure assessment, mitral valve analysis were performed at baseline and at 6 months in an independent core-center lab. CRTSR were defined as a reduction of end-systolic volume of at least 15% and an ejection fraction (EF)>50% and were compared to normal responder patients (CRTNo, patients with a reduction of end-systolic volume of at least 15% but an EF <50%). 17/186 patients (9.1%) were identified as CRTSR, only 2 with ischemic cardiomyopathy (p<0.01). No difference was observed regarding NYHA status, EKG duration or EF between CRTSR and CRTNo at baseline. CRTSR presented with significant lower end-diastolic and end-systolic diameters (64±9mm vs 73±9mm (p<0.01) and 53±7.4mm vs 63±8.4mm (p<0.01), respectively), and end-diastolic and end-systolic volumes 161±44ml vs 210±76ml (p<0.02) and 123±43ml vs 163±69ml (p<0.01)) as well as a higher LV dP/dt max (714±251mmHg.s −1 vs 527±188 mmHg.s −1 (p<0.05)). Regarding strain analysis, CRTSR had significantly higher longitudinal values than CRTNo (−12.8±3% vs −9±2.6%, p<0.001) whereas no difference was observed for other components (p ns). Global longitudinal strain obtained by ROC curves was identified as the best parameter for predicting CRTSR with a cut-off value of −11% (Se=80%, Spe=87%, AUC=0.89, p<0.002) and was confirmed as an independent predictor by the logistic regression (RR: 21.3, p<0.0001). In a large multicenter study, CRT super-responders (EF>50%) were observed in 9% of the population and were associated with less-depressed LV function as determined by strain analysis. Global longitudinal strain appears to be the best predictor of CRTSR.

scholarly journals Left ventricular remodelling and change in left ventricular global longitudinal strain after cardiac resynchronization therapy: prognostic implications

2019 ◽  
Vol 20 (10) ◽  
pp. 1112-1119 ◽  
Author(s):  
Pieter van der Bijl ◽  
Marina V Kostyukevich ◽  
Mand Khidir ◽  
Nina Ajmone Marsan ◽  
Victoria Delgado ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Systolic Volume ◽  
Reverse Remodelling ◽  
Prognostic Implications

Abstract Aims Cardiac resynchronization therapy (CRT) can reduce left ventricular end-systolic volume (LVESV), and a decrease of ≥15% is defined as a response. CRT can also improve LV global longitudinal strain (GLS). Changes in LVESV and LV GLS are individually associated with outcome post-CRT. We investigated LVESV and LV GLS changes and prognostic implications of improvement in LVESV and/or LV GLS, compared with no improvement in either parameter. Methods and results Baseline and 6-month echocardiograms were analysed from CRT recipients with heart failure. LV reverse remodelling was defined as a ≥15% reduction in LVESV at 6 months post-CRT. A ≥5% absolute improvement in LV GLS was defined as a change in LV GLS. A total of 1185 patients were included (mean age 65 ± 10 years, 73% male), and those with an improvement in LVESV and LV GLS (n = 131, 11.1%) had significantly lower mortality compared with other groups. On multivariable analysis, an improvement in both LVESV and LV GLS [hazard ratio (HR): 0.47; 95% confidence interval (CI): 0.31–0.71; P < 0.001] or an improvement in either LVESV or LV GLS (HR: 0.57; 95% CI: 0.47–0.71; P < 0.001) were independently associated with better prognosis, compared with no improvement in either parameter. Conclusion Either a reduction in LVESV and/or an improvement in LV GLS at 6 months post-CRT are independently associated with improved long-term prognosis, compared with no change in both LVESV and LV GLS. This supports the use of LV GLS as a meaningful parameter in defining CRT response.

scholarly journals B-PO05-182 IS THERE A POINT IN EVALUATING RIGHT VENTRICULAR GLOBAL LONGITUDINAL STRAIN PRIOR TO CARDIAC RESYNCHRONIZATION THERAPY?

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S446
Author(s):  
Radu-Gabriel M. Vatasescu ◽  
Silvia Deaconu ◽  
Alina Scarlatescu ◽  
Ioana Petre ◽  
Gabriela Marascu ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy
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