Changes in global left ventricular function by multidirectional strain assessment in heart failure patients...

Area of Science:

• Cardiology
• Medical Imaging
• Heart Failure Management

Background:

• Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
• Assessing CRT's impact on left ventricular (LV) mechanics is crucial.

Purpose of the Study:

• Evaluate acute and late effects of CRT on multidirectional LV strain.
• Utilize 2D speckle-tracking imaging and automated function imaging (AFI).

Main Methods:

• Measured LV strain (radial, circumferential, longitudinal) in 141 heart failure patients pre-CRT, post-CRT, and at 3-6 month follow-up.
• Assessed acute effects by interrupting CRT.
• Defined CRT response as ≥15% decrease in LV end-systolic volume.

Main Results:

• 57% of patients were responders; baseline strain values were similar between responders and non-responders.
• Responders showed significant improvements in LV strain, reverse LV remodeling, and ejection fraction at follow-up.
• No significant acute changes in LV strain were observed immediately post-CRT or upon device interruption.

Conclusions:

• 2D speckle-tracking imaging and AFI effectively quantify multidirectional LV mechanics.
• Improved LV strain after CRT is a long-term effect.
• LV strain improvement is linked to reverse LV remodeling post-CRT.