scholarly journals QRS duration as a predictor of left ventricular outflow tract velocity time integral in patient with cardiac resynchronization therapy

2020 ◽  
Vol 30 (2) ◽  
pp. 68
Author(s):  
MahaMohamed Mohamed Khalifa ◽  
Ahmed Said ◽  
Ayman Mortada ◽  
Hassan Shehata
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Velocity Time Integral ◽  
Time Integral ◽  
Left Ventricular Outflow ◽  
Qrs Duration

scholarly journals Correlation between QRS duration and cardiac output measured by left ventricular outflow tract velocity in patient with cardiac resynchronization therapy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A S A E Elshikh ◽  
M M Khalifa ◽  
H Shehata ◽  
A Murtada
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Left Ventricular Outflow ◽  
Qrs Duration ◽  
Post Implantation

Abstract Background Cardiac resynchronization therapy (CRT) is proved as an effective treatment for moderate to severe heart failure. It reduces all-cause mortality in patients with advanced heart failure. There is strong evidence that CRT reduces mortality and hospitalization, improves cardiac function and structure in symptomatic chronic heart failure patients with optimal medical treatment, severely depressed LVEF (i.e. <35%) and complete LBBB. However 30% of patients may show negative response to CRT therapy. Therefore, optimization of CRT therapy in patients with heart failure seems to be a main subject for study in our researches. Methods of optimization includes optimization of medical therapy, control of risk factors and comorbidities, and optimization of device implantation and programming. Overall, studying the correlation between QRS duration and cardiac output will improve CRT programming optimization techniques. Aim To study the correlation between QRS duration and cardiac output measured by left ventricular outflow tract (LVOT) VTI in patients with CRT implantation. Methods Study included 100 CRT already implanted patients, they are requested to do a simple electrocardiographic and echocardiographic study. The relation between post implant QRS and cardiac output are studied among the patients. Results There was negative significant correlation between QRS duration and LVOT VTI and SVi. The optimal cut off values for optimal response to CRT using ROC curves were 130msec for post implant QRS duration and 17.1 cm for LVOT VTI. Conclusion CRT response is more in female patients with lower BSA, and without previous history of IHD or smoking. There is a significant negative correlation between QRS duration and LVOT VTI. Post implantation cut off value of QRS duration (<130) predict higher LVOT VTI and also the post implantation benefit for the patient with CRT implanted.

scholarly journals Relationship of left ventricular outflow tract velocity time integral to treatment strategy in submassive and massive pulmonary embolism

2020 ◽  
Vol 10 (3) ◽  
pp. 204589402095372
Author(s):  
David Antoine ◽  
Taylor Chuich ◽  
Ruben Mylvaganam ◽  
Chris Malaisrie ◽  
Benjamin Freed ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Velocity Time Integral ◽  
Systemic Thrombolysis ◽  
Percent Change ◽  
Time Integral ◽  
Left Ventricular Outflow

Pulmonary embolism is associated with high rates of mortality and morbidity. It is important to understand direct comparisons of current interventions to differentiate favorable outcomes and complications. The objective of this study was to compare ultrasound-accelerated thrombolysis versus systemic thrombolysis versus anticoagulation alone and their effect on left ventricular outflow tract velocity time integral. This was a retrospective cohort study of subjects ≥18 years of age with a diagnosis of submassive or massive pulmonary embolism. The primary outcome was the percent change in left ventricular outflow tract velocity time integral between pre- and post-treatment echocardiograms. Ultrasound-accelerated thrombolysis compared to anticoagulation had a greater improvement in left ventricular outflow tract velocity time integral, measured by percent change. No significant change was noted between the ultrasound-accelerated thrombolysis and systemic thrombolysis nor systemic thrombolysis and anticoagulation groups. Pulmonary artery systolic pressure only showed a significant reduction in the ultrasound-accelerated thrombolysis versus anticoagulation group. The percent change of right ventricular to left ventricular ratios was improved when systemic thrombolysis was compared to both ultrasound-accelerated thrombolysis and anticoagulation. In this retrospective study of submassive or massive pulmonary embolisms, left ventricular outflow tract velocity time integral demonstrated greater improvement in patients treated with ultrasound-accelerated thrombolysis as compared to anticoagulation alone, a finding not seen with systemic thrombolysis. While this improvement in left ventricular outflow tract velocity time integral parallels the trend seen in mortality outcomes across the three groups, it only correlates with changes seen in pulmonary artery systolic pressure, not in other markers of echocardiographic right ventricular dysfunction (tricuspid annular plane systolic excursion and right ventricular to left ventricular ratios). Changes in left ventricular outflow tract velocity time integral, rather than echocardiographic markers of right ventricular dysfunction, may be considered a more useful prognostic marker of both dysfunction and improvement after reperfusion therapy.

OPTIMIZATION ATRIOVENTRICULAR DELAY USING ECHOGRAPHY FOR CARDIAC RESYNCHRONIZATION THERAPY PATIENTS

2017 ◽  
pp. 113-118
Author(s):  
Tri Thuc Nguyen ◽  
Cuu Long Nguyen
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Optimization Methods ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Velocity Time Integral ◽  
Mitral Inflow ◽  
Atrioventricular Delay ◽  
Time Integral ◽  
Invasive Hemodynamics

Objective: To determine correlation of echo-doppler optimization of atrioventricular delay in cardiac resynchronization therapy with left ventricular invasive hemodynamics optimization. Methods: Intervention prospective study. Result: In 25 patients (48% female, mean age 6.1±10.6, had diagnosis heart failure NYHA IIIV with LVEF= 26.9±5.7%, sinus rhythm, QRS wide is 170±22.1 ms) who underwent CRT. AVsense optimization were determined by invasive LV dP/dtmax, and the Doppler echocardiographic methods evaluated were the velocity–time integral (VTI) of the transmitralflow (EA VTI), the VTI of the LV outflow tractor aorta (LV VTI). The result are 117.8±15.2ms; 117.2±14.5ms and 120.8 ± 12.8ms, prospectively. The optimal AVsense delay with the EA VTI method was most concordant with LV dP/dtmax(r=0,953), LV VTI was less concordant (r=0.568). The result of AVpace optimization by three methods are 159.6±17.9ms; 159±16.2ms và 165±13.8ms, prospectively. The optimal AVpace delay with the EA VTI method was most concordant with LV dP/dtmax (r=0.964), LV VTI was less concordant (r=0.734). Conclusions: Comparing with invasive LV dP/dtmax, measurement of the maximal VTI of mitral inflow is more concordant than LV VTI in AVsense and AVpace optimization. If we optimize AVsense and AVpace, for replacing invasive LV dP/dtmax, EA VTI method was better option. Key words: Dyssychronization, CRT, optimization, dP/dtmax

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