Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Index of contractile asymmetry improves patient selection for CRT: a proof-of-concept study

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Respiratory influence on left atrial volume calculation with 3D-echocardiography

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Total average diastolic longitudinal displacement by colour tissue doppler imaging as an assessment of diastolic function

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Clinical usefulness of FDG-PET/CT for identification of abnormal extra-cardiac foci in patients with infective endocarditis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Level of Physical Activity, Left Ventricular Mass, Hypertension, and Prognosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Early Systolic Lengthening in Patients With ST-Segment-Elevation Myocardial Infarction: A Novel Predictor of Cardiovascular Events

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. External validation of the HANDOC score - high sensitivity to identify patients with non-beta-haemolytic streptococcal endocarditis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Nearly one-third of heart failure (HF) patients do not respond to cardiac resynchronization therapy (CRT) despite having left bundle branch block (LBBB). The aim of the study was to investigate a novel method of quantifying left ventricular (LV) contractile asymmetry in HF.

METHODS: Patients with HF and LBBB undergoing CRT (n = 89, 37.1% females, 68 ± 9 years, ischemic etiology in 61%, LV ejection fraction 27.1 ± 7.1%) were analyzed. LV longitudinal systolic strain rate values were extracted from curved anatomical M-mode plots of standard long-axis 2D-echocardiography images and cubic spline interpolation was used to generate a 3D-phantom. Index of contractile asymmetry (ICA) was calculated based on standard deviation of differences in strain rate of opposing walls. Average ICA was individually assessed pairwise in 12 opposing 30-degree LV sectors. Reduction in LV end-systolic volume (ESV) ≥15% after 6 months was considered as positive response to CRT.

RESULTS: CRT response was found in 66 (74.2%) patients. Responders with both ischemic and non-ischemic cardiomyopathy had a higher and more extensive contractile asymmetry at baseline and achieved a greater ICA reduction after CRT than non-responders. Higher baseline ICA predicted higher degree and wider extent of ICA improvement. Also, both ICA at baseline and reduction of ICA correlated with the degree of ESV reduction after CRT.

CONCLUSIONS: Quantification of asymmetrical LV activation in 3D by ICA provides valuable insights into LV contraction in case of LBBB and is a promising tool for improved patient selection for CRT.

Original languageEnglish
JournalCardiovascular Ultrasound
Volume17
Issue number1
Pages (from-to)19
ISSN1476-7120
DOIs
Publication statusPublished - 10 Oct 2019

ID: 59170229