open access

Vol 13, No 4 (2018)
Original Papers
Published online: 2018-09-12
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The relationship of regional longitudinal strain changes and response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch block

Anna Lisowska, Katarzyna Ptaszyńska-Kopczyńska, Marta Marcinkiewicz-Siemion, Małgorzata Knapp, Marcin Witkowski, Bożena Sobkowicz, Włodzimierz Jerzy Musiał, Karol Adam Kamiński
DOI: 10.5603/FC.2018.0066
·
Pubmed: 10405908
·
Folia Cardiologica 2018;13(4):289-297.

open access

Vol 13, No 4 (2018)
Original Papers
Published online: 2018-09-12

Abstract

Introduction. Strain and strain rate (SR) are techniques, which provide local information on myocardial deformation. The aim of the study was to assess the usefulness of strain and SR measurement in cardiac resynchronization therapy (CRT) response in chronic heart failure (CHF) patients.

Materials and methods. The study included 35 CHF patients with QRS complex duration ≥ 120ms with LBBB morphology. Biochemical and clinical parameters were assessed before and after six months of CRT. TTE classical and tissue Doppler echocardiography parameters (longitudinal peak systolic strain — LPS and SR for basal segment of intraventricular septum and lateral wall) were evaluated.

Results. Twenty-two patients (62.8%) benefited from CRT (the responders) and revealed improvement in septal and lateral LPS in the 6-month observation [-7.1 (-5.2– -11.1) vs -12.1 (-8.7– -14)%, p = 0.002; - 10.4 (-6.1– -17.6) vs - 13.8 (-8.9 – -17.8)%, p = 0.03; respectively]. Six months after CRT, the responders were characterised by higher increase in septal LPS comparing to the nonresponders (-4.6 ± 6.1 vs -2.4 ± 3.9%, p = 0.045). Septal LPS changes correlated positively with baseline cardiopulmonary exercise testing (CPET) parameters: peak oxygen uptake (r = 0.6, p = 0.004), peak carbon dioxide excretion (r = 0.62, p = 0.002) and negatively with VE/VCO2 slope (r = -0.5, p = 0.037).

Conclusions. LV regional LPS appears to be a good parameter reflecting the improvement of clinical status in patients treated with CRT. The responders had better improvement of septal LPS, therefore positive response to this therapy may be related to the improvement of septal contractility.

Abstract

Introduction. Strain and strain rate (SR) are techniques, which provide local information on myocardial deformation. The aim of the study was to assess the usefulness of strain and SR measurement in cardiac resynchronization therapy (CRT) response in chronic heart failure (CHF) patients.

Materials and methods. The study included 35 CHF patients with QRS complex duration ≥ 120ms with LBBB morphology. Biochemical and clinical parameters were assessed before and after six months of CRT. TTE classical and tissue Doppler echocardiography parameters (longitudinal peak systolic strain — LPS and SR for basal segment of intraventricular septum and lateral wall) were evaluated.

Results. Twenty-two patients (62.8%) benefited from CRT (the responders) and revealed improvement in septal and lateral LPS in the 6-month observation [-7.1 (-5.2– -11.1) vs -12.1 (-8.7– -14)%, p = 0.002; - 10.4 (-6.1– -17.6) vs - 13.8 (-8.9 – -17.8)%, p = 0.03; respectively]. Six months after CRT, the responders were characterised by higher increase in septal LPS comparing to the nonresponders (-4.6 ± 6.1 vs -2.4 ± 3.9%, p = 0.045). Septal LPS changes correlated positively with baseline cardiopulmonary exercise testing (CPET) parameters: peak oxygen uptake (r = 0.6, p = 0.004), peak carbon dioxide excretion (r = 0.62, p = 0.002) and negatively with VE/VCO2 slope (r = -0.5, p = 0.037).

Conclusions. LV regional LPS appears to be a good parameter reflecting the improvement of clinical status in patients treated with CRT. The responders had better improvement of septal LPS, therefore positive response to this therapy may be related to the improvement of septal contractility.

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Keywords

strain, echocardiography, cardiac resynchronization therapy, chronic heart failure, left bundle branch block

About this article
Title

The relationship of regional longitudinal strain changes and response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch block

Journal

Folia Cardiologica

Issue

Vol 13, No 4 (2018)

Pages

289-297

Published online

2018-09-12

DOI

10.5603/FC.2018.0066

Pubmed

10405908

Bibliographic record

Folia Cardiologica 2018;13(4):289-297.

Keywords

strain
echocardiography
cardiac resynchronization therapy
chronic heart failure
left bundle branch block

Authors

Anna Lisowska
Katarzyna Ptaszyńska-Kopczyńska
Marta Marcinkiewicz-Siemion
Małgorzata Knapp
Marcin Witkowski
Bożena Sobkowicz
Włodzimierz Jerzy Musiał
Karol Adam Kamiński

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