Authors: ChunLi Wang ChiaTung Wu YungHsin Yeh LungSheng Wu YiHsin Chan ChiTai Kuo PaoHsien Chu LungAn Hsu WanJing Ho
Publish Date: 2017/02/01
Volume: 33, Issue: 6, Pages: 869-877
Abstract
A left bundlebranch block LBBB contraction pattern identified from longitudinalstrain analysis predicts outcomes following cardiac resynchronization therapy CRT We investigated the use of an LBBBcontraction pattern identified from radial or circumferentialstrain analysis in the prediction of CRT benefits Eighty CRT candidates were prospectively enrolled Before CRT implantation speckletracking analyses in three deformation directions were performed to determine whether an LBBBcontraction pattern was present The study endpoints were reverse remodeling at 6 months and adverse outcomes including death or heart failure hospitalization At 6 months 49 61 patients had reverse remodeling An LBBBcontraction pattern identified from the radial strain in the midventricular shortaxis view or longitudinal strain in the fourchamber view provided excellent truepositive 86 and falsenegative 8 rates for predicting reverse remodeling During a median followup of 30 months 31 patients 39 had adverse outcomes Absence of an LBBBcontraction pattern in radial hazard ratio 374 95 confidence interval 183–762 or longitudinal strain hazard ratio 349 95 confidence interval 171–713 was significantly associated with an increased risk of adverse outcomes Adding the LBBBpattern assessment by radialmodel χ2 from 82 to 185 p = 0005 or longitudinalstrain analysis model χ2 from 82 to 169 p = 0011 to a risk model significantly improved the model including QRS duration and ischemic etiology In conclusion an LBBBcontraction pattern identified from radialstrain analysis in the midventricular shortaxis view predicted reverse remodeling and outcome following CRT similarly to the longitudinalstrain analysis
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