Septal Deformation Patterns Delineate Mechanical Dyssynchrony and Regional Differences in Contractility Analysis of Patient Data Using a Computer Model

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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

98 Citations (Web of Science)


Background-Response to cardiac resynchronization therapy depends both on dyssynchrony and (regional) contractility. We hypothesized that septal deformation can be used to infer integrated information on dyssynchrony and regional contractility, and thereby predict cardiac resynchronization therapy response. Methods and Results-In 132 cardiac resynchronization therapy candidates with left bundle branch block (LBBB)-like electrocardiogram morphology (left ventricular ejection fraction 19 +/- 6%; QRS width 170 +/- 23 ms), longitudinal septal strain was assessed by speckle tracking echocardiography. To investigate the effects of dyssynchronous activation and differences in septal and left ventricular free wall contractility on septal deformation pattern, we used the CircAdapt computer model of the human heart and circulation. In the patients, 3 characteristic septal deformation patterns were identified: LBBB-1=double-peaked systolic shortening (n=28); LBBB-2=early systolic shortening followed by prominent systolic stretching (n=34); and LBBB-3=pseudonormal shortening with less pronounced late systolic stretch (n=70). LBBB-3 revealed more scar (2[2-5] segments) compared with LBBB-1 and LBBB-2 (both 0 [0-1], P
Original languageEnglish
Pages (from-to)87-96
JournalCirculation-Heart Failure
Issue number1
Publication statusPublished - Jan 2012


  • bundle-branch block
  • cardiac resynchronization therapy
  • dyssynchrony
  • echocardiography
  • myocardial contraction

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