TY - JOUR
T1 - Strain imaging to predict response to cardiac resynchronization therapy
T2 - a systematic comparison of strain parameters using multiple imaging techniques
AU - Zweerink, Alwin
AU - van Everdingen, Wouter M.
AU - Nijveldt, Robin
AU - Salden, Odette A. E.
AU - Meine, Mathias
AU - Maass, Alexander H.
AU - Vernooy, Kevin
AU - de Langer, Frederik J.
AU - Vos, Marc A.
AU - Croisille, Pierre
AU - Clarysse, Patrick
AU - Geelhoed, Bastiaan
AU - Rienstra, Michiel
AU - van Gelder, Isabelle C.
AU - van Rossum, Albert C.
AU - Cramer, Maarten J.
AU - Allaart, Cornelis P.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Aims Various strain parameters and multiple imaging techniques are presently available including cardiovascular magnetic resonance (CMR) tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). This study aims to compare predictive performance of different strain parameters and evaluate results per imaging technique to predict cardiac resynchronization therapy (CRT) response. Methods and results Twenty-seven patients were prospectively enrolled and underwent CMR and echocardiographic examination before CRT implantation. Strain analysis was performed in circumferential (CMR-TAG, CMR-FT, and STE-circ) and longitudinal (STE-long) orientations. Regional strain values, parameters of dyssynchrony, and discoordination were calculated. After 12 months, CRT response was measured by the echocardiographic change in left ventricular (LV) end-systolic volume (LVESV). Twenty-six patients completed follow-up; mean LVESV change was -29 +/- 27% with 17 (65%) patients showing >= 15% LVESV reduction. Measures of dyssynchrony (SD-TTPLV) and discoordination (ISFLV) were strongly related to CRT response when using CMR-TAG (R-2 0.61 and R-2 0.57, respectively), but showed poor correlations for CMR-FT and STE (all R-2 <= 0.32). In contrast, the end-systolic septal strain (ESSsep) parameter showed a consistent high correlation with LVESV change for all techniques (CMR-TAG R-2 0.60; CMR-FT R-2 0.50; STE-circ R-2 0.43; and STE-long R-2 0.43). After adjustment for QRS duration and QRS morphology, ESSsep remained an independent predictor of response per technique. Conclusions End-systolic septal strain was the only parameter with a consistent good relation to reverse remodelling after CRT, irrespective of assessment technique. In clinical practice, this measure can be obtained by any available strain imaging technique and provides predictive value on top of current guideline criteria.
AB - Aims Various strain parameters and multiple imaging techniques are presently available including cardiovascular magnetic resonance (CMR) tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). This study aims to compare predictive performance of different strain parameters and evaluate results per imaging technique to predict cardiac resynchronization therapy (CRT) response. Methods and results Twenty-seven patients were prospectively enrolled and underwent CMR and echocardiographic examination before CRT implantation. Strain analysis was performed in circumferential (CMR-TAG, CMR-FT, and STE-circ) and longitudinal (STE-long) orientations. Regional strain values, parameters of dyssynchrony, and discoordination were calculated. After 12 months, CRT response was measured by the echocardiographic change in left ventricular (LV) end-systolic volume (LVESV). Twenty-six patients completed follow-up; mean LVESV change was -29 +/- 27% with 17 (65%) patients showing >= 15% LVESV reduction. Measures of dyssynchrony (SD-TTPLV) and discoordination (ISFLV) were strongly related to CRT response when using CMR-TAG (R-2 0.61 and R-2 0.57, respectively), but showed poor correlations for CMR-FT and STE (all R-2 <= 0.32). In contrast, the end-systolic septal strain (ESSsep) parameter showed a consistent high correlation with LVESV change for all techniques (CMR-TAG R-2 0.60; CMR-FT R-2 0.50; STE-circ R-2 0.43; and STE-long R-2 0.43). After adjustment for QRS duration and QRS morphology, ESSsep remained an independent predictor of response per technique. Conclusions End-systolic septal strain was the only parameter with a consistent good relation to reverse remodelling after CRT, irrespective of assessment technique. In clinical practice, this measure can be obtained by any available strain imaging technique and provides predictive value on top of current guideline criteria.
KW - Cardiovascular magnetic resonance (CMR)
KW - Myocardial tagging (CMR-TAG)
KW - Feature tracking (CMR-FT)
KW - Speckle tracking echocardiography (STE)
KW - Myocardial strain analysis
KW - Cardiac resynchronization therapy (CRT)
KW - BUNDLE-BRANCH BLOCK
KW - SEPTAL REBOUND STRETCH
KW - MECHANICAL DYSSYNCHRONY
KW - MAGNETIC-RESONANCE
KW - ECHOCARDIOGRAPHY
KW - CONTRACTION
KW - IMPROVEMENT
KW - PATTERN
KW - STRICT
U2 - 10.1002/ehf2.12335
DO - 10.1002/ehf2.12335
M3 - Article
C2 - 30051598
SN - 2055-5822
VL - 5
SP - 1130
EP - 1140
JO - Esc heart failure
JF - Esc heart failure
IS - 6
ER -