Regional Strain Pattern Index—A Novel Technique to Predict CRT Response

Michał Orszulak, Artur Filipecki, Wojciech Wróbel, Adrianna Berger-Kucza, Witold Orszulak, Dagmara Urbańczyk-Swić, Wojciech Kwaśniewski, Edyta Płońska-Gościniak and Katarzyna Mizia-Stec
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Michał Orszulak: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Artur Filipecki: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Wojciech Wróbel: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Adrianna Berger-Kucza: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Witold Orszulak: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Dagmara Urbańczyk-Swić: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Wojciech Kwaśniewski: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland
Edyta Płońska-Gościniak: Department of Cardiology, Pomeranian Medical University, 70-204 Szczecin, Poland
Katarzyna Mizia-Stec: First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland

IJERPH, 2021, vol. 18, issue 3, 1-12

Abstract: Background: Cardiac resynchronization therapy (CRT) improves outcome in patients with heart failure (HF) however approximately 30% of patients still remain non-responsive. We propose a novel index—Regional Strain Pattern Index (RSPI)—to prospectively evaluate response to CRT. Methods: Echocardiography was performed in 49 patients with HF (66.5 ± 10 years, LVEF 24.9 ± 6.4%, QRS width 173.1 ± 19.1 ms) two times: before CRT implantation and 15 ± 7 months after. At baseline, dyssynchrony was assessed including RSPI and strain pattern. RSPI was calculated from all three apical views across 12 segments as the sum of dyssynchronous components. From every apical view, presence of four components were assessed: (1) contraction of the early-activated wall; (2) prestretching of the late activated wall; (3) contraction of the early-activated wall in the first 70% of the systolic ejection phase; (4) peak contraction of the late-activated wall after aortic valve closure. Each component scored 1 point, thus the maximum was 12 points. Results: Responders reached higher mean RSPI values than non-responders (5.86 ± 2.9 vs. 4.08 ± 2.4; p = 0.044). In logistic regression analysis value of RSPI ≥ 7 points was a predictor of favorable CRT effect (OR: 12; 95% CI = 1.33–108.17; p = 0.004). Conclusions: RSPI could be a valuable predictor of positive outcome in HF patients treated with CRT.

Keywords: cardiac resynchronization therapy; dyssynchrony; strain pattern; heart failure; RSPI (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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