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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@article{1606836, author = {Šipula, David and Kozák, Milan and Sipula, Jaroslav and Homza, Miroslav and Plasek, Jiri}, article_location = {Warsaw}, article_number = {1}, doi = {http://dx.doi.org/10.1515/med-2019-0111}, keywords = {Cardiac Resynchronization Therapy; Heart Failure; Optimization; Speckle Tracking; Cardiac Strains}, language = {eng}, issn = {2391-5463}, journal = {Open Medicine}, title = {Cardiac strains as a tool for optimization of cardiac resynchronization therapy in non-responders: a pilot study}, url = {http://dx.doi.org/10.1515/med-2019-0111}, volume = {14}, year = {2019} }
TY - JOUR ID - 1606836 AU - Šipula, David - Kozák, Milan - Sipula, Jaroslav - Homza, Miroslav - Plasek, Jiri PY - 2019 TI - Cardiac strains as a tool for optimization of cardiac resynchronization therapy in non-responders: a pilot study JF - Open Medicine VL - 14 IS - 1 SP - 945-952 EP - 945-952 PB - Walter De Gruyter SN - 23915463 KW - Cardiac Resynchronization Therapy KW - Heart Failure KW - Optimization KW - Speckle Tracking KW - Cardiac Strains UR - http://dx.doi.org/10.1515/med-2019-0111 L2 - http://dx.doi.org/10.1515/med-2019-0111 N2 - 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. ER -
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. \textit{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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