PMID- 21810831
OWN - NLM
STAT- MEDLINE
DCOM- 20120118
LR  - 20220318
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 13
IP  - 9
DP  - 2011 Sep
TI  - Multicentre study using strain delay index for predicting response to cardiac 
      resynchronization therapy (MUSIC study).
PG  - 984-91
LID - 10.1093/eurjhf/hfr073 [doi]
AB  - AIMS: Strain delay index (SDI) allows quantification of the wasted contraction or 
      gain of myocardial contractility expected after cardiac resynchronization therapy 
      (CRT). The present multicentre prospective study aimed to assess the accuracy of 
      the SDI in predicting responses to CRT in real-life patients with wide and narrow 
      (<130 ms) QRS complexes. METHODS AND RESULTS: Implantation of a CRT device was 
      performed in 235 heart failure patients and echocardiography data were analysable 
      in 80% (n= 189) of patients (age 65 +/- 12 years, left ventricular ejection 
      fraction = 26 +/- 8%, 63 ischaemic, 51 with narrow QRS complexes). Mechanical 
      dyssynchrony before CRT was quantified by the 12-segment standard deviation of 
      peak longitudinal strain by speckle tracking (12SD-epsilon, 12 standard deviation of 
      time to peak strain by speckle tracking), and SDI, defined as the sum of 
      difference between end-systolic and peak-epsilon across the 16 segments. Response to 
      CRT was defined as an end-systolic volume reduction (ESVR) at 6 months >15%. 
      After CRT, ESVR>15% was observed in 60% (n= 114/189) of patients, and was greater 
      in non-ischaemic (68 vs. 44%, P= 0.003) and wide QRS patients (65 vs. 49%, P= 
      0.04). Correlation between 12SD-epsilon and ESVR was poor (r = 0.18, P= 0.01). In 
      contrast, SDI correlated with reverse remodelling (r = 0.61, P< 0.0001 for all) 
      in both wide and narrow QRS patients and ischaemic and non-ischaemic patients. 
      Decrease in SDI after CRT was greater in responders and correlated with ESVR. 
      Finally, SDI > 25% identified responders to CRT (positive and negative predictive 
      value of 80 and 84%, respectively) with 6% inter-observer variability. 
      CONCLUSION: The present multicentre study suggests that SDI may identify 
      responders to CRT in ischaemic and non-ischaemic patients.
FAU - Lim, Pascal
AU  - Lim P
AD  - Cardiovascular Department, Henri Mondor University Hospital (APHP and INSERM 
      U841), Creteil, France. lim.pascal.hmn@gmail.com
FAU - Donal, Erwan
AU  - Donal E
FAU - Lafitte, Stephane
AU  - Lafitte S
FAU - Derumeaux, Genevieve
AU  - Derumeaux G
FAU - Habib, Gilbert
AU  - Habib G
FAU - Reant, Patricia
AU  - Reant P
FAU - Thivolet, Sophie
AU  - Thivolet S
FAU - Lellouche, Nicolas
AU  - Lellouche N
FAU - Grimm, Richard A
AU  - Grimm RA
FAU - Gueret, Pascal
AU  - Gueret P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20110802
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Defibrillators, Implantable
MH  - Echocardiography, Doppler
MH  - Female
MH  - France
MH  - Heart Failure/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*physiopathology
EDAT- 2011/08/04 06:00
MHDA- 2012/01/19 06:00
CRDT- 2011/08/04 06:00
PHST- 2011/08/04 06:00 [entrez]
PHST- 2011/08/04 06:00 [pubmed]
PHST- 2012/01/19 06:00 [medline]
AID - hfr073 [pii]
AID - 10.1093/eurjhf/hfr073 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2011 Sep;13(9):984-91. doi: 10.1093/eurjhf/hfr073. Epub 2011 
      Aug 2.