Mechanistic Evaluation of Echocardiographic Dyssynchrony Indices Patient Data Combined With Multiscale Computer Simulations

Joost Lumens*, Geert E. Leenders, Maarten Jan Cramer, Bart W. L. De Boeck, Pieter A. Doevendans, Frits W. Prinzen, Tammo Delhaas

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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
Original languageEnglish
Pages (from-to)491-499
JournalCirculation-Cardiovascular Imaging
Issue number4
Publication statusPublished - Jul 2012


  • echocardiography
  • heart failure
  • strain
  • computer model
  • asynchrony

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