Related Experiment Video
Updated: Jul 11, 2026
12:45
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Combined longitudinal and radial dyssynchrony predicts ventricular response after resynchronization therapy
John Gorcsan1, Masaki Tanabe, Gabe B Bleeker
1Cardiovascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15213-2582, USA. gorcsanj@upmc.edu
Journal of the American College of Cardiology
|October 9, 2007
Summary
Combined echocardiographic measures of longitudinal and radial dyssynchrony effectively predict left ventricular (LV) functional response to cardiac resynchronization therapy (CRT). This approach offers improved prediction accuracy compared to individual assessments.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Management
Background:
- Mechanical left ventricular (LV) dyssynchrony is a known predictor of response to cardiac resynchronization therapy (CRT).
- Complex patterns of dyssynchrony may influence treatment outcomes.
- Accurate prediction of CRT response remains a clinical challenge.
Purpose of the Study:
- To evaluate the hypothesis that combined echocardiographic assessment of longitudinal and radial dyssynchrony predicts LV functional response to CRT.
- To determine if combining tissue Doppler imaging (TDI) and speckle-tracking strain improves prediction accuracy.
Main Methods:
- Studied 190 heart failure patients undergoing CRT.
- Assessed longitudinal dyssynchrony using color TDI (2-site and 12-site).
- Assessed radial dyssynchrony using speckle-tracking strain.
- Defined LV response as a >=15% increase in ejection fraction (EF).
Main Results:
- Combined longitudinal and radial dyssynchrony predicted EF response with 88% sensitivity and 80% specificity.
- When both dyssynchrony types were positive, 95% of patients showed an EF response.
- Combined assessment was significantly better than either method alone (p < 0.0001).
Conclusions:
- Combined assessment of longitudinal and radial dyssynchrony is a powerful predictor of LV functional response to CRT.
- This integrated echocardiographic approach enhances the ability to identify likely responders to CRT.
- Future research may refine these echocardiographic parameters for personalized CRT selection.
Related Concept Videos
01:25Assessment of apical radial pulse
Apical-Radial (A-R) Pulse Assessment
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:11Assessment of radial pulse
Assessment of Radial Pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:30Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
01:15Dysrhythmias I: Introduction
Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:25Correlation between ECG and Cardiac Cycle
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...