Association between echocardiography-derived haemodynamic force parameters and left ventricular reverse remodelling...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Imaging

Background:

• Cardiac resynchronization therapy (CRT) is used for heart failure patients.
• Left ventricular (LV) reverse remodeling (LV response) is a key outcome of CRT.
• Intraventricular pressure gradients, quantified by echocardiography-derived haemodynamic forces (HDF), may predict CRT response.

Purpose of the Study:

• To assess the association between baseline HDF and LV response to CRT.
• To compare changes in HDF after CRT between LV responders and non-responders.

Main Methods:

• Echocardiography-derived HDF parameters (apical-basal strength, lateral-septal strength, force vector angle, systolic AB impulse, systolic force vector angle) were analyzed.
• LV response was defined as ≥15% reduction in LV end-systolic volume at 6 months.
• Multivariable logistic regression identified predictors of LV response.

Main Results:

• 196 patients (69% with LV response) were included.
• Baseline force vector angle (complete cycle and systolic) independently predicted LV response.
• Post-CRT, LV responders showed improved apical-basal strength and impulse, and higher force vector angles compared to non-responders.

Conclusions:

• Baseline HDF orientation is linked to CRT-induced LV response.
• HDF orientation improves post-CRT in both responders and non-responders.
• Magnitude of apical-basal HDF improvement is specific to LV responders.