TY - JOUR
T1 - Mechanistic Evaluation of Echocardiographic Dyssynchrony Indices Patient Data Combined With Multiscale Computer Simulations
AU - Lumens, Joost
AU - Leenders, Geert E.
AU - Cramer, Maarten Jan
AU - De Boeck, Bart W. L.
AU - Doevendans, Pieter A.
AU - Prinzen, Frits W.
AU - Delhaas, Tammo
PY - 2012/7
Y1 - 2012/7
N2 - Background-The power of echocardiographic dyssynchrony indices to predict response to cardiac resynchronization therapy (CRT) appears to vary between indices and between studies. We investigated whether the variability of predictive power between the dyssynchrony indices can be explained by differences in their operational definitions. Methods and Results-In 132 CRT-candidates (left ventricular [LV] ejection fraction, 19 +/- 6%; QRS width, 170 +/- 22 ms), 4 mechanical dyssynchrony indices (septal systolic rebound stretch [SRSsept], interventricular mechanical dyssynchrony [IVMD], septal-to-lateral peak shortening delay [Strain-SL], and septal-to-posterior wall motion delay [SPWMD]) were quantified at baseline. CRT response was quantified as 6-month percent change of LV end-systolic volume. Multiscale computer simulations of cardiac mechanics and hemodynamics were used to assess the relationships between dyssynchrony indices and CRT response within wide ranges of dyssynchrony of LV activation and reduced contractility. In patients, SRSsept showed best correlation with CRT response followed by IVMD, Strain-SL, and SPWMD (R=-0.56, -0.50, -0.48, and -0.39, respectively; all P
AB - Background-The power of echocardiographic dyssynchrony indices to predict response to cardiac resynchronization therapy (CRT) appears to vary between indices and between studies. We investigated whether the variability of predictive power between the dyssynchrony indices can be explained by differences in their operational definitions. Methods and Results-In 132 CRT-candidates (left ventricular [LV] ejection fraction, 19 +/- 6%; QRS width, 170 +/- 22 ms), 4 mechanical dyssynchrony indices (septal systolic rebound stretch [SRSsept], interventricular mechanical dyssynchrony [IVMD], septal-to-lateral peak shortening delay [Strain-SL], and septal-to-posterior wall motion delay [SPWMD]) were quantified at baseline. CRT response was quantified as 6-month percent change of LV end-systolic volume. Multiscale computer simulations of cardiac mechanics and hemodynamics were used to assess the relationships between dyssynchrony indices and CRT response within wide ranges of dyssynchrony of LV activation and reduced contractility. In patients, SRSsept showed best correlation with CRT response followed by IVMD, Strain-SL, and SPWMD (R=-0.56, -0.50, -0.48, and -0.39, respectively; all P
KW - echocardiography
KW - heart failure
KW - strain
KW - computer model
KW - asynchrony
U2 - 10.1161/CIRCIMAGING.112.973446
DO - 10.1161/CIRCIMAGING.112.973446
M3 - Article
C2 - 22661491
SN - 1941-9651
VL - 5
SP - 491
EP - 499
JO - Circulation-Cardiovascular Imaging
JF - Circulation-Cardiovascular Imaging
IS - 4
ER -