Experimental and clinical studies ot prediction of response to cardiac resynchronization therapy by real-time three-dimensional echocardiography and speckle tracking imaging
10.3760/cma.j.issn.1004-4477.2011.08.007
- VernacularTitle:实时三维超声和斑点追踪显像预测心脏再同步化治疗疗效的实验和临床研究
- Author:
Xianhong SHU
;
Xue GONG
;
Yongshi WANG
;
Jie CUI
;
Cuizhen PAN
;
Yangang SU
- Publication Type:Journal Article
- Keywords:
Echocardiography,real-time three-dimensional;
Speckle tracking imaging;
Cardiac resynchronization therapy;
Ventricular function,left
- From:Chinese Journal of Ultrasonography
2011;20(8):665-668
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate new parameters to predict the response to cardiac resynchronization therapy (CRT) by using real-time three-dimensional echocardiography (RT3DE) and speckle tracking imaging(STI). Methods Twenty-one adult beagle dogs were divided into three groups:group A (CRT group, n =10) ,group B (heart failure group, n =7) and group C (control group, n =4).Seventy patients who accepted CRT and were followed up 6 months after CRT were enrolled. Response to CRT was defined as a ≥15％ decrease in left ventricular end-systolic volume. RT-3DE parameters were the dispersion of time to minimum regional volume for 16 segments (Tmsv16-SD) ,and the ratio of Tmsv16-SD to R-R interval (SDI). STI parameters were the ratios of standard deviation of the time to peak radial and circumferential strain at midventricular level to R-R interval (Trs-6SD,Tcs-6SD). Results In experimental study,Tmsv-16SD, Trs-6SD, Tcs-6SD had negative relationship with left veutricular ejection fraction (r were - 0. 86, - 0.75, - 0.83 respectively, all P ＜0.01 ). Trs-6SD was the strongest predictor to CRT. A cut-off value of Trs-6SD≥12.2％ was able to predict response to CRT with a sensitivity of 83.3％ and a specificity of 100％. Clinical studies found SDI was the strongest predictor to CRT. A cut-off value of SDI≥6.55％ was able to predict response to CRT with a sensitivity of 80. 0％ and a specificity of 81.8％.Conclusions RT-3DE and STI can assess left ventricular dyssynchrony, and are promising methods to predict the response to CRT.
