Optimization of pulsed wave tissue Doppler to predict left ventricular reverse remodeling after cardiac resynchronization therapy

J Am Soc Echocardiogr. 2006 Feb;19(2):185-91. doi: 10.1016/j.echo.2005.08.021.

Abstract

Objective: The optimal use of pulsed wave Doppler tissue imaging (DTI) in predicting left ventricular (LV) reverse remodeling after cardiac resynchronization therapy (CRT) was investigated.

Methods: DTI was performed in 69 patients before and 3 months after CRT. Echocardiographic reverse remodeling was observed in 38 patients. LV dyssynchrony was measured with the time to onset or peak systolic velocity in 2- and 6-basal segment models.

Results: The time to onset and either the standard deviation of 6 segments of > 20 ms or a delay of > or = 60 ms between any 2 of 6 segments had a similar predictive accuracy (sensitivity, 97% and 95%, respectively; specificity, 74% and 73%, respectively). The time to peak systolic velocity or evaluating 2 segments was less accurate.

Conclusions: Evaluation of 6 segments is necessary to predict LV reverse remodeling after CRT. The time to onset of systolic velocity is superior to the time to peak velocity.

MeSH terms

  • Aged
  • Cardiac Pacing, Artificial / methods*
  • Echocardiography, Doppler, Pulsed / methods*
  • Female
  • Heart Failure / complications
  • Heart Failure / therapy*
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Prognosis
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Stroke Volume*
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Remodeling*