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Effects of strain dyssynchrony index on response evaluations in patients with cardiac resynchronization therapy postoperatively |
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Abstract Objective To investigate the effects of strain dyssynchrony index(SDI) on response evaluations in patients with cardiac resynchronization therapy(CRT) postoperatively.MethodsThe synchrony and systolic function of left ventricle of 25 patients with CRT were evaluated with conventional echocardiography, tissue Doppler imaging and speckle tracking imaging before and 6 months after CRT procedure respectively. The longitudinal, radial and circumferential SDI was calculated as the average sum of difference between the corresponding peak strain and endsystolic peak respectively. Meanwhile, changes in patients’ heart function before and 6 months after CRT procedure were also assessed according to clinical and echocardiographic performance. Response to CRT in clinic was defined as improvement of more than 1 class in heart function grade. Response to CRT in echocardiography was defined as reduction in left ventricular endsystolic volume ≥15% 6 months after CRT.ResultsAmong the 3 SDI, radial SDI≥6.6% was the best predictor of response to CRT, with sensitivity of 83%, specificity of 83%, and an area of 0.88 beneath the curve (P<0.001). Circumferential SDI≥3.2% and longitudinal SDI ≥3.5% were also found to be predictive of response to CRT, with areas of 0.78 and 0.76 beneath the curve, respectively(P<0.05). The rate of response to CRT in patients with 3 positive SDIs was 100%. Moreover, radial, circumferential and longitudinal SDI at baseline were correlated with reduction of left ventricular endsystolic volume.ConclusionThe radial SDI can well predict patients’ response to CRT postoperatively, whereas a combination of 3 SDI proves to be more accurate.
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