Cardiac resynchronization therapy (CRT) has became an alternative treatment in patients with severe medically refractory heart failure in recent years. Several large studies have demonstrated the effectiveness of CRT, which can improve the atrioventricular, interventricular, and intraventricular dyssynchronies. Echocardiography can be used to evaluate cardiac mechanical synchrony by means of M-mode, pulse Doppler, tissue Doppler, 3D, and other techniques, and can therefore be used to screen patients, select lead location, optimize pacemaker parameters, and follow up patients who have undergone CRT. This article reviews the strength and shortcomings of some commonly used echocardiographic techniques when they are applied in patients with heart failure.
Cardiac Pacing, Artificial ; Heart Failure ; diagnostic imaging ; therapy ; Humans ; Ultrasonography

Heart Failure/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Stroke Volume ; Ventricular Function, Left

Heart Failure ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pleural Effusion ; diagnostic imaging ; Tomography, X-Ray Computed ; Ventricular Dysfunction, Left ; diagnostic imaging

OBJECTIVETo review the updated research progress about the application of echocardiography in resynchronization treatment of chronic heart failure patients.

DATA SOURCESThe data used in this review were from PubMed, published in English and using the key terms "heart failure", "echocardiography" and "cardiac resynchronization therapy".

STUDY SELECTIONRelevant articles were reviewed and selected to address the stated purpose.

RESULTSIncreasing numbers of studies have suggested the importance of echocardiography in resynchronization treatment of chronic heart failure patients. Echocardiography can evaluate atrioventricular, inter- and intra-ventricular mechanical dyssynchrony before cardiac resynchronization therapy (CRT), as a guidance to assess the optimal left ventricular (LV) pacing location, optimize the atrioventricular and interventricular delays and predict response to CRT.

CONCLUSIONSEchocardiography is both non invasive and easily repeatable, and plays a crucial role in appraisal of heart synchronism, instruction of actuator placement, optimization of the device procedure, and prediction of the response to CRT.

Cardiac Resynchronization Therapy ; methods ; Echocardiography ; methods ; Heart Failure ; diagnostic imaging ; therapy ; Humans ; Radiography

Aged ; Cardiac Pacing, Artificial ; adverse effects ; Echocardiography ; methods ; Heart Failure ; diagnostic imaging ; etiology ; Humans ; Male

Heart failure is a disease that seriously threatens human health and has become a global public health problem. Diagnostic and prognostic analysis of heart failure based on medical imaging and clinical data can reveal the progression of heart failure and reduce the risk of death of patients, which has important research value. The traditional analysis methods based on statistics and machine learning have some problems, such as insufficient model capability, poor accuracy due to prior dependence, and poor model adaptability. In recent years, with the development of artificial intelligence technology, deep learning has been gradually applied to clinical data analysis in the field of heart failure, showing a new perspective. This paper reviews the main progress, application methods and major achievements of deep learning in heart failure diagnosis, heart failure mortality and heart failure readmission, summarizes the existing problems and presents the prospects of related research to promote the clinical application of deep learning in heart failure clinical research.
Humans ; Artificial Intelligence ; Deep Learning ; Heart Failure/diagnosis* ; Machine Learning ; Diagnostic Imaging

Left anterior fascicular block (LAFB) is a heart disease identifiable from an abnormal electrocardiogram (ECG). It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis.
Adult ; Bundle-Branch Block/diagnostic imaging* ; Computer Simulation ; Electrocardiography ; Heart/diagnostic imaging* ; Heart Atria/diagnostic imaging* ; Heart Conduction System/physiopathology* ; Heart Failure/diagnostic imaging* ; Heart Ventricles/diagnostic imaging* ; Humans ; Male ; Models, Anatomic ; Models, Theoretical ; Muscle Cells ; Myocardium ; Phantoms, Imaging ; Poisson Distribution

OBJECTIVETo quantitatively assess the left ventricular systolic dyssynchrony in patients with chronic heart failure based on the regional systolic dyssynchrony index (R-SDI) derived from real-time three-dimensional echocardiography (RT-3DE), and investigate the relation between R-SDI and the left ventricular systolic function.

METHODSForty-two patients with chronic heart failure (LVEF<50%) were classified into severe dysfunction group (group A, LVEF<40%) and mild dysfunction group (group B, LVEF≥40%), with 33 healthy subjects as the control group (LVEF>50%). RT-3DE was performed for each subject to obtain the left volume-time curves and the 16, 12, and 6 segment R-SDI. The value of R-SDI in assessing left ventricular systolic dyssynchrony and its correlation with LVEF were analyzed.

RESULTSThe 16, 12, and 6R-SDI were significantly higher in the chronic heart failure group than in the control group (P<0.01). The R-SDI of group A was significantly greater than those of group B in the chronic heart failure patients (P<0.01), and 16R-SDI, 12R-SDI, and 6R-SDI were inversely correlated with LVEF of the patients (r=-0.843, -0.840, and -0.841, respectively, P<0.01).

CONCLUSIONSR-SDI can be used to assess the left ventricular mechanic systolic dyssynchrony, and the degree of the dyssynchrony is inversely correlated with LVEF. RT-3DE can serve as a valuable modality for quantitative evaluation of left ventricular dyssynchrony in chronic heart failure patients.

Adult ; Aged ; Case-Control Studies ; Chronic Disease ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Failure ; diagnostic imaging ; Heart Ventricles ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Systole ; Ventricular Dysfunction, Left ; diagnostic imaging ; Ventricular Function, Left

OBJECTIVETo determine the feasibility and accuracy of high-frequency ultrasound in evaluating the left ventricular (LV) structure and function in normal and pressure overload rats and to examine the changes of the left ventricle during its transition from hypertrophy to heart failure.

METHODSThirty-eight female rats were randomly assigned to normal (n = 10), operated (n = 16) and sham-operated (n = 12) groups. Parasternal long axis and short axis images were acquired by a 7.5 mHz linear ultrasound probe at 12 weeks and 20 weeks after the operation respectively.

RESULTSLeft ventricular structure and function could be satisfactorily imaged for dimensions and mass. Compared to the sham-operated groups, at 12 weeks after the operation, the operated rats had increased LV wall thickness and mass (P < 0.01) with normal cavity and FS% (P > 0.05). At 20 weeks after the operation, the LV wall thickness showed no further progressive change and the LV mass increased greatly with slightly dilated LV cavity and decreased FS% (P < 0.05).

CONCLUSIONSHigh-frequency echocardiography provides a useful means to noninvasively evaluate LV dimensions, mass and function in rats. It will have great value for evaluating LV remodeling during the transition from LV hypertrophy to heart failure, as well as the effects of intervening drugs.

Animals ; Disease Progression ; Echocardiography ; methods ; Female ; Heart Failure ; diagnostic imaging ; pathology ; physiopathology ; Heart Ventricles ; diagnostic imaging ; pathology ; physiopathology ; Hypertrophy, Left Ventricular ; diagnostic imaging ; pathology ; physiopathology ; Rats ; Rats, Wistar ; Stress, Mechanical ; Ventricular Pressure ; physiology

OBJECTIVE: To quantitatively detect variation in regional myocardial systolic function in heart failure rat model induced by myocardial infarction by strain and strain rate imaging. METHODS: Seventy 2-month-old adult male SD rats were randomly assigned to 4 groups: a 4-week and a 8-week group after the operation (each n = 25) had thoracotomy, the pericardium opened and the anterior descending branch of left coronary artery ligated; a sham operation group (n = 10) had thoracotomy and the arcula cordis opened, but did not ligate the artery; a control group (n = 10) had no treatment. The changes of general state of health of the rats were observed and recorded every day. To assess the change of heart function, echocardiography was used at the end of the 4th week and 8th week after the surgery. To evaluate the change of heart function in heart failure rats, we quantitatively analyzed the regional myocardial systolic function in all rats by strain and strain rate imaging and myocardium to detect the level of MMP-9 at the end of the 4th week and 8th week. The repeatability and discrepancies of the results were all analyzed. RESULTS: Obviously objective signs of heart failure manifested themselves in the survived mice 10 to 14 days after the surgery. Compared with the control group and the sham operation group, the fraction shortening (FS) and ejection fraction (EF) of the 4-week group after the operation were lower (P < 0.05), the left ventricle index (LV index) of the 8-week group after the operation was higher, left ventricle posterior wall index (LVPW index), interventricular septum index (IVS index), FS, and EF of the 8-week group after the operation were lower (P < 0.05), EF and FS of the 8-week group after the operation were lower than those of the 4-week group. Except the mid-inferior wall and base-inferior wall, the systolic peak strain, systolic peak strain rate, the strain of end-systole in all segments of the operation group were lower than those of the other 2 groups (P < 0.05). The post-systolic strain index of the operation group was higher than that of the other 2 groups (P < 0.05). CONCLUSION Strain and strain rate imaging of echocardiography can quantitatively evaluate the changing of regional myocardial systolic function in the heart failure rat model induced by myocardial infarction, with good repeatability.
Animals ; Heart Failure ; diagnostic imaging ; etiology ; physiopathology ; Heart Ventricles ; diagnostic imaging ; Male ; Myocardial Infarction ; complications ; diagnostic imaging ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Systole ; Ultrasonography ; Ventricular Function, Left ; physiology