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Regional correlation by color-coded tissue Doppler to quantify improvements in mechanical left ventricular synchrony

Hideaki Kanzaki1, Didier Jacques, L Elif Sade

  • 1Cardiovascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA.

Insights

Cardiac resynchronization therapy (CRT) improves heart function in heart failure patients with left bundle branch block. A new mitral annular velocity index shows significant improvement after CRT.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Heart failure (HF) with left bundle branch block (LBBB) is associated with impaired cardiac synchrony.
  • Cardiac resynchronization therapy (CRT) is a treatment option for selected HF patients.
  • Assessing cardiac synchrony is crucial for optimizing CRT response.

Purpose of the Study:

  • To evaluate a novel synchrony index derived from mitral annular velocity (MAV) using color tissue Doppler.
  • To assess the effectiveness of this index in patients undergoing CRT.

Main Methods:

  • A study involving 19 subjects: 9 patients with HF and LBBB, and 10 healthy controls.
  • MAV-derived synchrony index measured at baseline, and 1, 3, and 6 months post-CRT in patients.
  • Comparison of synchrony index between HF patients and controls, and changes over time after CRT.

Main Results:

  • Baseline synchrony index was significantly lower in HF patients with LBBB compared to controls (r = 0.60 ± 0.13 vs 0.94 ± 0.02; p < 0.01).
  • The synchrony index in HF patients improved significantly at 6 months after CRT (r = 0.77 ± 0.09; p < 0.05 vs baseline).

Conclusions:

  • The MAV-derived synchrony index effectively differentiates cardiac synchrony between healthy individuals and HF patients with LBBB.
  • This index shows significant improvement following CRT, indicating its potential as a tool to monitor treatment response.

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