PMID- 16882676
OWN - NLM
STAT- MEDLINE
DCOM- 20070329
LR  - 20061004
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 27
IP  - 20
DP  - 2006 Oct
TI  - Comparison of segmental and global markers of dyssynchrony in predicting clinical 
      response to cardiac resynchronization.
PG  - 2426-32
AB  - AIMS: Cardiac resynchronization therapy (CRT) reduces inter- and intraventricular 
      dyssynchrony and shortens total isovolumic time (t-IVT). We compared the extent 
      to which the values of ventricular dyssynchrony and t-IVT predict clinical 
      benefits of CRT. METHODS AND RESULTS: Ventricular dyssynchrony was assessed in 39 
      patients with heart failure before and 6 months after CRT. Segmental dyssynchrony 
      was identified from time to onset and peak systolic velocity of wall motion. 
      T-IVT (s/min) was derived as [60-(total ejection time+total filling time)]. The 
      difference between ventricular pre-ejection periods (D-PEP) was calculated. 
      Outcome measures were fall in New York Heart Association (NYHA) class and 
      increase in cardiac output (CO). Following CRT, NYHA class fell in 29/39 
      patients, CO increased (by 1.0 L/min, P < 0.001), and intraventricular delay 
      (Intra-VD), interventricular delay (Inter-VD), t-IVT, and D-PEP shortened (by 25 
      ms, 72 ms, 6 s/min, and 38 ms, P < 0.01). NYHA class and CO were unchanged with 
      CRT in 10/39, and Intra-VD, Inter-VD, t-IVT, and D-PEP lengthened (by 43 ms, 52 
      ms, 7 s/min, and 35 ms, P < 0.05). Though univariate predictors of CO increment 
      with CRT were Intra-VD, Inter-VD, t-IVT, and D-PEP, only pre-CRT values of CO (P 
      < 0.001), t-IVT (P < 0.001), and D-PEP (P = 0.025) were independent. CONCLUSION: 
      Global, rather than segmental, measures of ventricular dyssynchrony are powerful, 
      independent predictors of clinical response to CRT.
FAU - Duncan, Alison M
AU  - Duncan AM
AD  - Department of Echocardiography, Royal Brompton Hospital and, Imperial College, 
      Sydney Street, London SW3 6NP, UK. a.duncan@imperial.ac.uk
FAU - Lim, Eric
AU  - Lim E
FAU - Clague, Jonathan
AU  - Clague J
FAU - Gibson, Derek G
AU  - Gibson DG
FAU - Henein, Michael Y
AU  - Henein MY
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060801
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2006 Oct;27(20):2380-1. PMID: 16966340
MH  - Aged
MH  - Analysis of Variance
MH  - Blood Flow Velocity/physiology
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cross-Sectional Studies
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Pacemaker, Artificial
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/physiopathology/*therapy
EDAT- 2006/08/03 09:00
MHDA- 2007/03/30 09:00
CRDT- 2006/08/03 09:00
PHST- 2006/08/03 09:00 [pubmed]
PHST- 2007/03/30 09:00 [medline]
PHST- 2006/08/03 09:00 [entrez]
AID - ehl179 [pii]
AID - 10.1093/eurheartj/ehl179 [doi]
PST - ppublish
SO  - Eur Heart J. 2006 Oct;27(20):2426-32. doi: 10.1093/eurheartj/ehl179. Epub 2006 
      Aug 1.