TY - JOUR

T1 - Predicting response to cardiac resynchronization therapy with cross-correlation analysis of myocardial systolic acceleration: a new approach to echocardiographic dyssynchrony evaluation

AU - Olsen, Niels Thue

AU - Mogelvang, Rasmus

AU - Jons, Christian

AU - Fritz-Hansen, Thomas

AU - Sogaard, Peter

N1 - Keywords: Aged; Algorithms; Cardiac Pacing, Artificial; Echocardiography, Doppler; Female; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Male; Middle Aged; Prognosis; Regression Analysis; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Treatment Outcome; Ventricular Dysfunction, Left

PY - 2009

Y1 - 2009

N2 - BACKGROUND: We tested the ability of cross-correlation analysis of myocardial systolic acceleration (XCA), a new marker of dyssynchrony based on tissue Doppler echocardiography, to predict long-term outcome of cardiac resynchronization therapy (CRT) and to discriminate between control patients and patients with dyssynchrony. METHODS: XCA was performed by off-line analysis of digitally stored myocardial velocity curves in 44 patients treated with CRT and followed for 13 +/- 2 months. We tested the ability of preimplant XCA to identify long-term responders to CRT (defined by a decrease in left ventricular end-systolic volume > 15%). Dyssynchrony findings were compared between CRT responders and 83 age-matched control patients with narrow QRS complexes and different levels of systolic cardiac dysfunction. XCA was compared with conventional dyssynchrony analysis based on differences in time-to-peak myocardial velocity. RESULTS: XCA was able to discriminate between long-term responders and nonresponders to CRT (area under the curve [AUC] = 0.66), but not significantly better than conventional analysis (AUC = 0.58). XCA showed large differences between the control groups and the CRT group (P < .01 for all), and had a higher discriminatory ability between normal controls and responders to CRT than conventional analysis (AUC = 0.95 vs 0.75, P < .01). CONCLUSION: XCA significantly improves the assessment of intraventricular dyssynchrony, and dyssynchrony by this method is associated with positive long-term response to CRT.

AB - BACKGROUND: We tested the ability of cross-correlation analysis of myocardial systolic acceleration (XCA), a new marker of dyssynchrony based on tissue Doppler echocardiography, to predict long-term outcome of cardiac resynchronization therapy (CRT) and to discriminate between control patients and patients with dyssynchrony. METHODS: XCA was performed by off-line analysis of digitally stored myocardial velocity curves in 44 patients treated with CRT and followed for 13 +/- 2 months. We tested the ability of preimplant XCA to identify long-term responders to CRT (defined by a decrease in left ventricular end-systolic volume > 15%). Dyssynchrony findings were compared between CRT responders and 83 age-matched control patients with narrow QRS complexes and different levels of systolic cardiac dysfunction. XCA was compared with conventional dyssynchrony analysis based on differences in time-to-peak myocardial velocity. RESULTS: XCA was able to discriminate between long-term responders and nonresponders to CRT (area under the curve [AUC] = 0.66), but not significantly better than conventional analysis (AUC = 0.58). XCA showed large differences between the control groups and the CRT group (P < .01 for all), and had a higher discriminatory ability between normal controls and responders to CRT than conventional analysis (AUC = 0.95 vs 0.75, P < .01). CONCLUSION: XCA significantly improves the assessment of intraventricular dyssynchrony, and dyssynchrony by this method is associated with positive long-term response to CRT.

U2 - 10.1016/j.echo.2009.03.017

DO - 10.1016/j.echo.2009.03.017

M3 - Journal article

C2 - 19423287

VL - 22

SP - 657

EP - 664

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 6

ER -