Easy-to-use comprehensive speckle-tracking approach for cardiac resynchronization therapy

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Left ventricular (LV) dyssynchrony is a key factor in cardiac resynchronization therapy (CRT) response.
• LV myocardial viability also influences CRT outcomes.
• A simple, combined assessment method is needed.

Purpose of the Study:

• To evaluate the combined prognostic value of LV dyssynchrony and global circumferential strain (GCS) in patients undergoing CRT.
• To determine if LV dyssynchrony and GCS independently predict cardiovascular events.
• To assess the efficiency of a combined speckle-tracking strain analysis.

Main Methods:

• Studied 132 patients undergoing CRT.
• Assessed LV dyssynchrony using anteroseptal-to-posterior wall delay (≥130 ms) via 2D speckle-tracking radial strain.
• Determined global circumferential strain (GCS) from the same mid-LV short-axis view.

Main Results:

• Patients with GCS >3.9% had fewer cardiovascular events (log-rank P=0.034).
• Both LV dyssynchrony and GCS were independently associated with cardiovascular events (multivariate Cox analysis).
• Analysis of both parameters from the same view took only 2±1 min per patient.

Conclusions:

• Combined assessment of LV dyssynchrony and GCS using speckle-tracking strain is efficient and prognostic.
• This easy-to-use method from a single view may have significant clinical implications for CRT patient selection and management.