Related Experiment Video
Updated: May 9, 2026
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
Left ventricular 12 segmental strain imaging predicts response to cardiac resynchronization therapy
Ying-Xue Dong1, Jae K Oh, Yan-Zong Yang
1Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
Insights
The standard deviation of time to peak myocardial strain (Tε-SD) in 12 segments is a promising predictor for cardiac resynchronization therapy (CRT) response. This echocardiographic parameter can help identify patients likely to benefit from CRT, improving treatment selection.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Management
Background:
- High rates of non-response to cardiac resynchronization therapy (CRT) necessitate improved patient selection.
- Echocardiographic parameters are being investigated to predict CRT response.
- Identifying responders is crucial for optimizing heart failure treatment.
Purpose of the Study:
- To identify echocardiographic parameters that predict response to cardiac resynchronization therapy (CRT).
- To evaluate the utility of strain patterns in predicting CRT outcomes.
Main Methods:
- Prospective study of 45 heart failure patients receiving CRT-D.
- Echocardiographic parameters, including strain patterns (Tε-SD), were assessed pre- and post-CRT.
- Response defined as ≥15% decrease in left ventricular end-systolic volume (LVESV) at 6 months.
Main Results:
- 48.9% of patients responded to CRT, showing significant improvements in NYHA class, LVEDV, and 6-minute walk distance.
- Responders exhibited higher interventricular mechanical delay and Tε-SD compared to non-responders.
- Multivariate analysis identified Tε-SD as a significant predictor of CRT response (OR = 1.02, P = 0.02).
Conclusions:
- Left ventricular 12-segment strain imaging, specifically Tε-SD, is a promising echocardiographic tool for predicting CRT response.
- This parameter can aid in selecting patients who are most likely to benefit from CRT.
- Further validation of strain imaging for CRT patient selection is warranted.
Background:
The number of non-responders to cardiac resynchronization therapy (CRT) exposes the need for better patient selection criteria for CRT. This study aimed to identify echocardiographic parameters that would predict the response to CRT.
Methods:
Forty-five consecutive patients receiving CRT-D implantation for heart failure (HF) were included in this prospective study. New York Heart Association (NYHA) class, 6-minute walk distance, electrograph character, and multi echocardiographic parameters, especially in strain patterns, were measured and compared before and six months after CRT in the responder and non-responder groups. Response to CRT was defined as a decrease in left ventricular endsystolic volume (LVESV) of 15% or more at 6-month follow up.
Results:
Twenty-two (48.9%) patients demonstrated a response to CRT at 6-month follow-up. Significant improvement in NYHA class (P < 0.01), left ventricular end-diastolic volume (LVEDV) (P < 0.01), and 6-minute walk distance (P < 0.01) was shown in this group. Although there was an interventricular mechanical delay determined by the difference between left and right ventricular pre-ejection intervals ((42.87 ± 19.64) ms vs. (29.43 ± 18.19) ms, P = 0.02), the standard deviation of time to peak myocardial strain among 12 basal, mid and apical segments (Tε-SD) ((119.97 ± 43.32) ms vs. (86.62 ± 36.86) ms, P = 0.01) and the non-ischemic etiology (P = 0.03) were significantly higher in responders than non-responders, only the Tε-SD (OR = 1.02, 95% CI = 1.01 - 1.04, P = 0.02) proved to be a favorable predictor of CRT response after multivariate Logistic regression analysis.
Conclusion:
The left ventricular 12 segmental strain imaging is a promising echocardiographic parameter for predicting CRT response.
More Related Videos
11:50High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
Published on: July 9, 2010
09:05Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016