Strain Rate Dispersion Index Can Predict Changes in Left Ventricular Volume and Adverse Cardiac Events Following Cardiac Resynchronization Therapy

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概要

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• Background: We previously reported that the strain rate dispersion index (SRDI), an index of left ventricular (LV) contractility loss because of mechanical dyssynchrony, better predicted the acute response to cardiac resynchronization therapy (CRT) than time-delay indices. However, it remains unclear whether the SRDI can predict the chronic response. Additionally, the SRDI needs to be simplified for use in clinical practice. Methods and Results: Echocardiography was performed in 40 heart failure patients who underwent CRT. The SRDI, the average of segmental peak systolic strain rates minus global peak systolic strain rate, was calculated, together with strain-derived time-delay indices (St-SD) in the longitudinal, circumferential and radial directions using a speckle-tracking method. As simplified indices, the longitudinal parameters were calculated from the apical 4-chamber view in addition to 3 apical views. LV end-systolic volume (ESV) significantly decreased 6 months after CRT. Although circumferential St-SD and all SRDIs correlated with the changes in ESV (ΔESV), multivariate analysis revealed that the circumferential SRDI was the single independent determinant of ΔESV. During the 20±14 months after CRT, cardiac events occurred in 14 patients. Kaplan-Meier analyses revealed that all SRDIs were significant predictors of cardiac events whereas none of St-SDs was. Conclusions: The SRDI predicted the reduction in both LV volume and cardiac events after CRT better than time-delay indices. Additionally, a simplified SRDI could be as good a predictor of CRT response as the original.

著者

• Yokoshiki Hisashi

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• YAMADA Satoshi

  Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine

• MIKAMI Taisei

  Faculty of Health Sciences, Hokkaido University

• Tsutsui Hiroyuki

  Department Of Cardiovascular Medicine

• Yamada Satoshi

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• Nishida Mutsumi

  Division Of Clinical Laboratory And Transfusion Medicine Hokkaido University Hospital

• Iwano Hiroyuki

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• Mikami Taisei

  Faculty Of Health Sciences Hokkaido University

• Mitsuyama Hirofumi

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• Yokoyama Shinobu

  Division Of Clinical Laboratory And Transfusion Medicine Hokkaido University Hospital

• Watanabe Masaya

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• Nishino Hisao

  Division Of Clinical Laboratory And Transfusion Medicine Hokkaido University Hospital

• Nishida Mutsumi

  Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital

• Yokoyama Shinobu

  Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital

• Kaga Sanae

  Faculty of Health Sciences, Hokkaido University

• Mizukami Kazuya

  Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine

• Okada Kazunori

  Division of Health Sciences, Hokkaido University Graduate School of Health Sciences

• TSUTSUI Hiroyuki

  Department of Cardiology, Iizuka Hospital

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