Utility of comprehensive assessment of strain dyssynchrony index by speckle tracking imaging for predicting response to cardiac resynchronization therapy

Kazuhiro Tatsumi, Hidekazu Tanaka, Kouhei Yamawaki, Keiko Ryo, Alaa Mabrouk Salem Omar, Yuko Fukuda, Kazuko Norisada, Kensuke Matsumoto, Tetsuari Onishi, John Gorcsan, Akihiro Yoshida, Hiroya Kawai, Ken Ichi Hirata

Research output: Contribution to journalArticlepeer-review

Abstract

The strain delay index is reportedly a marker of dyssynchrony and residual myocardial contractility. The aim of this study was to test the hypothesis that a relatively simple version of the strain dyssynchrony index (SDI) can predict response to cardiac resynchronization therapy (CRT) and that combining assessment of radial, circumferential, and longitudinal SDI can further improve the prediction of responders. A total of 52 patients who underwent CRT were studied. The SDI was calculated as the average difference between peak and end-systolic strain from 6 segments for radial and circumferential SDI and 18 segments for longitudinal SDI. Conventional dyssynchrony measures were assessed by interventricular mechanical delay, the Yu index, and radial dyssynchrony by speckle tracking strain. Response was defined as a <15% decrease in end-systolic volume after 3 months. Of the individual parameters, radial SDI <6.5% was the best predictor of response to CRT, with sensitivity of 81%, specificity of 81%, and an area under the curve of 0.87 (p <0.001). Circumferential SDI <3.2% and longitudinal SDI <3.6% were also found to be predictive of response to CRT, with areas under the curve of 0.81 and 0.80, respectively (p <0.001). Moreover, radial, circumferential, and longitudinal SDI at baseline were correlated with reduction of end-systolic volume with CRT. In addition, the response rate in patients with 3 positive SDIs was 100%. In contrast, rates in patients with either 1 or no positive SDIs were 42% and 22%, respectively (p <0.005 and p <0.001 vs 3 positive SDIs). In conclusion, the SDI can successfully predict response to CRT, and the combined approach leads to more accurate prediction than using individual parameters.

Original languageEnglish (US)
Pages (from-to)439-446
Number of pages8
JournalAmerican Journal of Cardiology
Volume107
Issue number3
DOIs
StatePublished - Feb 1 2011

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Utility of comprehensive assessment of strain dyssynchrony index by speckle tracking imaging for predicting response to cardiac resynchronization therapy'. Together they form a unique fingerprint.

Cite this