Peak longitudinal strain delay is superior to TDI in the selection of XXXX for resynchronisation therapy.

@entity1 @entity712 @entity1054 @entity714
BACKGROUND: Mechanical dyssynchrony has proven to be superior to QRS duration in predicting response to cardiac resynchronisation therapy (CRT). Whether time to peak longitudinal strain delay between the mid-septum and mid-lateral left ventricular wall better predicts CRT response than tissue Doppler imaging (TDI) is unclear. This study compares the value of the two methods for the assessment of mechanical dyssynchrony and prediction of CRT responders. METHODS: 66 clinical responders and 17 nonresponders to CRT with severe @entity712 (LVEF <35%), New York Heart Association classification III or IV and a wide QRS >130 ms with @entity714 were evaluated by peak longitudinal strain and TDI. Doppler echocardiograms and @entity1054 ( @entity1054 ) intervals were acquired before and after pacemaker implantation. RESULTS: In all responders @entity1054 measured by peak longitudinal strain was >60 ms before implantation, compared with 76% of the @entity1 measured by TDI. Nonresponders had @entity1054 <60 ms measured by both techniques. Only peak longitudinal strain delay showed shortened values in every responder postimplantation and demonstrated the most significant reduction and could predict responders to CRT. However, @entity1054 measured by TDI did not diminish in 30% of the positive clinical responders. Nonresponders showed worsening of the @entity1054 with peak longitudinal strain, but not with TDI. CONCLUSIONS: Responders to CRT can be excellently predicted if @entity1054 before implantation determined by peak longitudinal strain delay is >60 ms. Peak longitudinal strain delay appears to be superior to TDI to predict the response to CRT. (Neth Heart J 2010;18:574-82.).
