Relationship Between Left Ventricular Remodeling Assessed by Strain Echocardiography and Conventional
Giang Song Tran1, Bang Phu Thi Hoang1, Si Dung Chu2
1Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam.
Insights
Strain echocardiography effectively monitors heart failure treatment. Cardiac resynchronization therapy (CRT) significantly improves left ventricular function and volume in patients with severe heart failure.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Management
Background:
- Left ventricular remodeling is a key factor in severe heart failure.
- Cardiac resynchronization therapy (CRT) aims to improve cardiac function in heart failure patients.
- Assessing remodeling pre- and post-CRT is crucial for treatment evaluation.
Purpose of the Study:
- To evaluate the relationship between left ventricular remodeling and echocardiographic parameters before and after CRT.
- To assess the utility of strain echocardiography in monitoring CRT effectiveness.
- To correlate echocardiographic findings with treatment outcomes in heart failure.
Main Methods:
- A descriptive study with follow-up comparison of 33 heart failure patients undergoing CRT.
- Echocardiography, including strain imaging, was performed before and three months after CRT implantation.
- Analysis focused on changes in left ventricular volumes, ejection fraction, and strain parameters.
Main Results:
- Significant reduction in left ventricular end-systolic and end-diastolic volumes post-CRT (p < 0.001).
- Strong inverse correlation between volume reduction and QRS recovery (r = 0.65).
- Positive correlations found between left atrial volume index and strain parameters, and between isovolumic relaxation time and left atrial volume index post-CRT.
Conclusions:
- Strain echocardiography is valuable for diagnosing and monitoring heart failure.
- CRT significantly improves left ventricular volume and ejection fraction after three months.
- Echocardiographic parameters, including strain, reflect treatment effectiveness in heart failure patients receiving CRT.
Background/Aims:
To assess the relationship between left ventricular remodeling as evaluated by strain echocardiography and conventional echocardiography before and after cardiac resynchronization therapy (CRT) in patients with severe heart failure.
Methods:
A cross-sectional descriptive study with follow-up comparison before and after CRT. The study included 33 heart failure patients indicated for CRT at the Vietnam National Heart Institute, Bach Mai Hospital from late 2015 to December 2021.
Results:
Left ventricular end-systolic volume and end-diastolic volume significantly decreased after three months of follow-up (p < 0.001) and showed a strong inverse correlation with QRS recovery (r = 0.65). A positive correlation was observed between changes in left atrial volume index (LAVI) and 4B strain (r = 0.96, p < 0.05). After three months of CRT implantation, positive correlations were observed between isovolumic relaxation time (IVRT) and left atrial volume index (LAVI), and between left atrial volume and E/e' obtained from tissue Doppler imaging (r = 0.53, p < 0.05). No correlation was found between E/e' and total EF, between 2B strain and total EF, or between 2B strain and LAVI.
Conclusion:
Strain echocardiography represents an important tool for diagnosing, assessing risk factors, and monitoring heart failure. After three months of CRT implantation, significant improvement in left ventricular volume and ejection fraction was observed, indicating improved treatment effectiveness.
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