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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Echocardiographic Parameters as Predictors for the Efficiency of Resynchronization Therapy in Patients with Dilated

Silvius-Alexandru Pescariu1,2,3,4, Raluca Şoşdean1,2,3, Cristina Tudoran5,6,7

  • 1Department VI, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.

Diagnostics (Basel, Switzerland)
|January 21, 2022
PubMed

Insights

Cardiac resynchronization therapy (CRT) improves outcomes for heart failure patients. Echocardiographic strain parameters correlate with CRT sensing and pacing, aiding treatment planning for better results.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Cardiac resynchronization therapy (CRT) is vital for managing symptomatic dilated cardiomyopathy (DCM) and heart failure with reduced ejection fraction (HFrEF) despite optimal medical therapy (OMT).
  • Challenges in CRT efficacy sometimes necessitate adjustments in sensing and pacing parameters, even with optimal lead placement.
  • Understanding factors influencing CRT response is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To investigate the relationship between transthoracic echocardiography (TTE) parameters, particularly left ventricular (LV) strain, and LV sensing/pacing parameters in HFrEF patients undergoing CRT.
  • To identify echocardiographic predictors of CRT sensing and pacing requirements.

Main Methods:

  • A cohort of 48 patients with DCM and HFrEF, symptomatic despite OMT, underwent CRT between 2020-2021.
  • Transthoracic echocardiography (TTE) was performed to assess LV performance, including global longitudinal strain (GLS) and posterolateral strain.
  • Statistical analysis explored correlations between TTE parameters (GLS, posterolateral strain, ejection fraction) and LV sensing/pacing parameters.

Main Results:

  • Significant correlations were found between GLS and LV sensing (r=0.65, p<0.001) and LV pacing (r=-0.567, p<0.001).
  • Posterolateral strain also correlated significantly with LV sensing (r=0.469, p<0.001) and LV pacing (r=-0.555, p<0.001).
  • Ejection fraction showed significant correlations with both LV sensing (r=0.534, p<0.001) and LV pacing (r=-0.363, p<0.001).

Conclusions:

  • Transthoracic echocardiography, especially with cardiac strain analysis, provides valuable insights into LV performance relevant to CRT.
  • These imaging techniques can help predict and manage sensing and pacing parameters, potentially increasing CRT success rates.
  • Integrating advanced TTE parameters into patient evaluation may enhance personalized CRT management strategies for HFrEF.

Keywords:
longitudinal strainpacing parameterssensing parameterstransthoracic echocardiography

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