ŠIPULA, David, Milan KOZÁK, Jaroslav SIPULA, Miroslav HOMZA and Jiri PLASEK. Cardiac strains as a tool for optimization of cardiac resynchronization therapy in non-responders: a pilot study. Open Medicine. Warsaw: Walter De Gruyter, 2019, vol. 14, No 1, p. 945-952. ISSN 2391-5463. Available from: https://dx.doi.org/10.1515/med-2019-0111.
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Basic information
Original name Cardiac strains as a tool for optimization of cardiac resynchronization therapy in non-responders: a pilot study
Authors ŠIPULA, David (203 Czech Republic, guarantor, belonging to the institution), Milan KOZÁK (203 Czech Republic, belonging to the institution), Jaroslav SIPULA (203 Czech Republic), Miroslav HOMZA (203 Czech Republic) and Jiri PLASEK (203 Czech Republic).
Edition Open Medicine, Warsaw, Walter De Gruyter, 2019, 2391-5463.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Poland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 1.204
RIV identification code RIV/00216224:14110/19:00112594
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1515/med-2019-0111
UT WoS 000501996200002
Keywords in English Cardiac Resynchronization Therapy; Heart Failure; Optimization; Speckle Tracking; Cardiac Strains
Tags 14110211, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 20/1/2020 07:59.
Abstract
Background. Approximately 30% of patients do not respond to implantation of Cardiac Resynchronization Therapy - Defibrillators (CRT-D). The aim of this study was to investigate the potential for cardiac strain speckle tracking to optimize the performance of CRT-D in non-responding patients. Methods. 30 patients not responding to Cardiac Resynchronization Therapy-Defibrillators after 3 months were randomly divided into control and intervention groups. Atrioventricular interval was adjusted so that E and A waves did not overlap, the interventricular interval was subsequently optimized to yield maximum improvement of the sum of longitudinal+radial+circumferential strains. The left ventricular ejection fraction (LVEF) and NYHA improvement 3 months after optimization were evaluated and use of other strain combinations assessed. Results. A significant correlation between the (combined) strain change and LVEF improvement was detected (p<0.01). 75% of patients with non-ischemic etiology of heart failure who did not respond to the original CRT-D reacted favorably with significant LVEF and NYHA improvement. The area strain was the best predictor of LVEF/NYHA improvement in those patients. No significant improvement was recorded in patients with ischemic etiology. Conclusions. AV and VV optimization based on speckle tracking is a very promising method potentially leading to a significant improvement of the outcome of CRT-D, especially in patients with non-ischemic etiology of heart failure.
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