Usefulness of Three-dimensional Speckle Tracking Strain to Quantify Dyssynchrony and the Site of Latest Mechanical Activation

Overview

Journal Am J Cardiol

Specialty Cardiology & Vascular Diseases

Date 2010 Jan 28

PMID 20102925

Citations 37

Authors

Hidekazu Tanaka

Hideyuki Hara

Samir Saba

John Gorcsan 3rd

Affiliations

Soon will be listed here.

Abstract

Previous methods to quantify dyssynchrony could not determine regional 3-dimensional (3-D) strain. We hypothesized that a novel 3-D speckle tracking strain imaging system can quantify left ventricular (LV) dyssynchrony and site of latest mechanical activation. We studied 64 subjects; 54 patients with heart failure were referred for cardiac resynchronization therapy (CRT) with an ejection fraction 25 +/- 6% and QRS interval 165 +/- 29 ms and 10 healthy volunteer controls. The 3-D speckle tracking system determined radial strain using a 16-segment model from a pyramidal 3-D dataset. Dyssynchrony was quantified as maximal opposing wall delay and SD in time to peak strain. The 3-D analysis was compared to standard 2-dimensional (2-D) strain datasets and site of 3-D latest mechanical activation, not possible by 2D was quantified. As expected, dyssynchrony in patients on CRT was significantly greater than in controls (maximal opposing wall delay 316 +/- 112 vs 59 +/- 12 ms and SD 124 +/- 48 vs 28 +/- 11 ms, p <0.001 vs normal). The 3-D opposing wall delay was closely correlated with 3-D 16-segment SD (r = 0.95) and 2-D mid-LV strain (r = 0.83) and SD (r = 0.85, all p values <0.001). The 3-D site of the latest mechanical activation was most commonly midposterior (26%), basal posterior (22%), midlateral (20%), and basal lateral (17%). Eleven patients studied after CRT demonstrated improvements in 3-D synchrony (300 +/- 124 to 94 +/- 37 ms) and ejection fraction (24 +/- 6% to 31 +/- 7%, p <0.05). In conclusion, 3-D speckle tracking can successfully quantify 3-D dyssynchrony and site the latest mechanical activation. This approach may play a clinical role in management of patients on CRT.

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References

Chung E, Leon A, Tavazzi L, Sun J, Nihoyannopoulos P, Merlino J . Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation. 2008; 117(20):2608-16. DOI: 10.1161/CIRCULATIONAHA.107.743120. View

Schiller N, Shah P, Crawford M, DeMaria A, Devereux R, FEIGENBAUM H . Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989; 2(5):358-67. DOI: 10.1016/s0894-7317(89)80014-8. View

Suffoletto M, Dohi K, Cannesson M, Saba S, Gorcsan 3rd J . Novel speckle-tracking radial strain from routine black-and-white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy. Circulation. 2006; 113(7):960-8. DOI: 10.1161/CIRCULATIONAHA.105.571455. View

Bax J, Bleeker G, Marwick T, Molhoek S, Boersma E, Steendijk P . Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J Am Coll Cardiol. 2004; 44(9):1834-40. DOI: 10.1016/j.jacc.2004.08.016. View

Lang R, Bierig M, Devereux R, Flachskampf F, Foster E, Pellikka P . Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of.... J Am Soc Echocardiogr. 2005; 18(12):1440-63. DOI: 10.1016/j.echo.2005.10.005. View

Ansalone G, Giannantoni P, Ricci R, Trambaiolo P, Fedele F, Santini M . Doppler myocardial imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing. J Am Coll Cardiol. 2002; 39(3):489-99. DOI: 10.1016/s0735-1097(01)01772-7. View

Gorcsan 3rd J, Kanzaki H, Bazaz R, Dohi K, Schwartzman D . Usefulness of echocardiographic tissue synchronization imaging to predict acute response to cardiac resynchronization therapy. Am J Cardiol. 2004; 93(9):1178-81. DOI: 10.1016/j.amjcard.2004.01.054. View

Sade L, Kanzaki H, Severyn D, Dohi K, Gorcsan 3rd J . Quantification of radial mechanical dyssynchrony in patients with left bundle branch block and idiopathic dilated cardiomyopathy without conduction delay by tissue displacement imaging. Am J Cardiol. 2004; 94(4):514-8. DOI: 10.1016/j.amjcard.2004.04.071. View

Grines C, Bashore T, Boudoulas H, Olson S, Shafer P, Wooley C . Functional abnormalities in isolated left bundle branch block. The effect of interventricular asynchrony. Circulation. 1989; 79(4):845-53. DOI: 10.1161/01.cir.79.4.845. View

10.

Ypenburg C, van Bommel R, Delgado V, Mollema S, Bleeker G, Boersma E . Optimal left ventricular lead position predicts reverse remodeling and survival after cardiac resynchronization therapy. J Am Coll Cardiol. 2008; 52(17):1402-9. DOI: 10.1016/j.jacc.2008.06.046. View

11.

Cleland J, Daubert J, Erdmann E, Freemantle N, Gras D, Kappenberger L . The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005; 352(15):1539-49. DOI: 10.1056/NEJMoa050496. View

12.

Saxon L, Olshansky B, Volosin K, Steinberg J, Lee B, Tomassoni G . Influence of left ventricular lead location on outcomes in the COMPANION study. J Cardiovasc Electrophysiol. 2009; 20(7):764-8. DOI: 10.1111/j.1540-8167.2009.01444.x. View

13.

Gorcsan 3rd J, Tanabe M, Bleeker G, Suffoletto M, Thomas N, Saba S . Combined longitudinal and radial dyssynchrony predicts ventricular response after resynchronization therapy. J Am Coll Cardiol. 2007; 50(15):1476-83. DOI: 10.1016/j.jacc.2007.06.043. View

14.

Sogaard P, Egeblad H, Kim W, Jensen H, Pedersen A, Kristensen B . Tissue Doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy. J Am Coll Cardiol. 2002; 40(4):723-30. DOI: 10.1016/s0735-1097(02)02010-7. View

15.

Dohi K, Suffoletto M, Schwartzman D, Ganz L, Pinsky M, Gorcsan 3rd J . Utility of echocardiographic radial strain imaging to quantify left ventricular dyssynchrony and predict acute response to cardiac resynchronization therapy. Am J Cardiol. 2005; 96(1):112-6. DOI: 10.1016/j.amjcard.2005.03.032. View

16.

Kapetanakis S, Kearney M, Siva A, Gall N, Cooklin M, Monaghan M . Real-time three-dimensional echocardiography: a novel technique to quantify global left ventricular mechanical dyssynchrony. Circulation. 2005; 112(7):992-1000. DOI: 10.1161/CIRCULATIONAHA.104.474445. View

17.

Notabartolo D, Merlino J, Smith A, DeLurgio D, Vera F, Easley K . Usefulness of the peak velocity difference by tissue Doppler imaging technique as an effective predictor of response to cardiac resynchronization therapy. Am J Cardiol. 2004; 94(6):817-20. DOI: 10.1016/j.amjcard.2004.05.072. View

18.

Tanabe M, Lamia B, Tanaka H, Schwartzman D, Pinsky M, Gorcsan 3rd J . Echocardiographic speckle tracking radial strain imaging to assess ventricular dyssynchrony in a pacing model of resynchronization therapy. J Am Soc Echocardiogr. 2008; 21(12):1382-8. PMC: 3001299. DOI: 10.1016/j.echo.2008.09.012. View

19.

van Dijk J, Knaapen P, Russel I, Hendriks T, Allaart C, de Cock C . Mechanical dyssynchrony by 3D echo correlates with acute haemodynamic response to biventricular pacing in heart failure patients. Europace. 2007; 10(1):63-8. DOI: 10.1093/europace/eum262. View

20.

Butter C, Auricchio A, Stellbrink C, Fleck E, Ding J, Yu Y . Effect of resynchronization therapy stimulation site on the systolic function of heart failure patients. Circulation. 2001; 104(25):3026-9. DOI: 10.1161/hc5001.102229. View