Related Experiment Video

Updated: Jan 22, 2026

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

Published on: October 20, 2016

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Discontinuous contraction in the left ventricle assessed by 2-D speckle tracking echocardiography benefits from CRT

Aya Fujii1, Yasuya Inden1, Satoshi Yanagisawa2

  • 1Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Pacing and Clinical Electrophysiology : PACE
|July 20, 2019
PubMed

Insights

Two-dimensional speckle tracking strain imaging can predict cardiac resynchronization therapy (CRT) responders in patients with left bundle-branch block (LBBB). Discontinuous left ventricular (LV) contraction patterns identified by this imaging technique are associated with positive CRT response.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Cardiac resynchronization therapy (CRT) improves outcomes for patients with left bundle-branch block (LBBB).
  • A significant portion of LBBB patients do not respond to CRT, necessitating predictive tools.
  • Previous research suggests that transmural functional line blocks influence left ventricular (LV) activation and predict CRT response.

Purpose of the Study:

  • To investigate the efficacy of 2-dimensional (2-D) speckle tracking strain imaging in predicting CRT responders among LBBB patients.
  • To determine if LV contraction patterns visualized by 2-D speckle tracking can identify patients likely to benefit from CRT.

Main Methods:

  • Fifty-four LBBB patients underwent echocardiography before and 6 months after CRT implantation.
  • Responders were defined as those with >15% decrease in LV end-systolic volume at 6 months.
  • The time difference to maximum strain between adjacent LV segments (Tmax-diff) was calculated and compared between responders and non-responders.

Main Results:

  • Thirty-seven of 54 patients were identified as responders.
  • Responders exhibited a significantly longer Tmax-diff (309.6 ± 168.6 ms) compared to non-responders (181.5 ± 138.4 ms, P = .009).
  • A Tmax-diff ≥ 195 ms, particularly in the septal and anterior areas, was associated with a higher likelihood of being a CRT responder (P = .02).

Conclusions:

  • 2-D speckle tracking strain imaging can detect discontinuous LV contraction in CRT responders.
  • This imaging modality shows promise as a tool for identifying specific contraction patterns in LBBB patients.
  • The findings suggest that 2-D speckle tracking strain imaging can effectively predict CRT response in LBBB patients.
Abstract

Keywords:
2-D speckle tracking strain imagingcardiac resynchronization therapyheart failureleft bundle-branch blockresponder

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