J 2019

Cardiac strains as a tool for optimization of cardiac resynchronization therapy in non-responders: a pilot study

ŠIPULA, David, Milan KOZÁK, Jaroslav SIPULA, Miroslav HOMZA, Jiri PLASEK et. al.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Poland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.204

RIV identification code

RIV/00216224:14110/19:00112594

Organization unit

Faculty of Medicine

UT WoS

000501996200002

Keywords in English

Cardiac Resynchronization Therapy; Heart Failure; Optimization; Speckle Tracking; Cardiac Strains

Tags

Tags

International impact, Reviewed
Změněno: 20/1/2020 07:59, Mgr. Tereza Miškechová

Abstract

V originále

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.