Left ventricular global longitudinal strain and mechanical dispersion predict response to multipoint pacing for cardiac resynchronization therapy

Zhu Mengruo; Chen Haiyan; Fulati Zibire; Liu Yang; Su Yangang; Shu Xianhong

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Left ventricular global longitudinal strain and mechanical dispersion predict response to multipoint pacing for cardiac resynchronization therapy

机译：左心室全局纵向应变和机械分散性预测心脏重新同步治疗的多点起搏的反应

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Purpose To evaluate the acute effect of multipoint pacing (MPP) and search for the better baseline predictors of response to MPP for guiding patient selection. Methods We enrolled 46 heart failure patients scheduled for implantation of MPP-enabled cardiac resynchronization therapy (CRT) devices. An acute pacing protocol including conventional CRT and MPP pacing configurations was performed after implantation. Echocardiography was used at baseline and during pacing test, and response was defined as left ventricular (LV) end-systolic volume (ESV) reduction >= 15% at 6-month follow-up. Results MPP response was present in 32 (69%) patients. Responders showed significantly superior LV ejection fraction, global longitudinal peak strain (GLPS), and mechanical dispersion (MD) with MPP than with conventional CRT (all P = 5.0% combined with MD >= 120 ms predicted MPP response with the optimal sensitivity of 91% and specificity of 71% (AUC = 0.848, P < 0.001). Conclusions MPP tends to be superior to conventional CRT in improving acute response. |GLPS| and MD can successfully predict response to MPP, and their combination can further improve the prediction accuracy of response.

机译：目的是评估多点起搏（MPP）的急性效应，并搜索对MPP的响应的更好基线预测因子进行引导患者选择。方法我们注册了46名心力衰竭患者，旨在植入MPP的心脏再同步治疗（CRT）器件。在植入后进行包括常规CRT和MPP起搏配置的急性起搏方案。超声心动图在基线中使用，并且在起搏试验期间，响应被定义为左心室（LV）末端收缩量（ESV）减少> = 15％在6个月的随访中。结果32例（69％）患者中存在MPP响应。响应者显示出显着优异的LV喷射分数，全局纵向峰值菌株（GLP）和MPP的机械分散（MD），而不是传统的CRT（所有P = 5.0％与MD> = 120 ms预测的MPP响应，最佳灵敏度为91 71％的特异性和特异性（AUC = 0.848，P <0.001）。结论MPP趋于优于传统的CRT，提高急性反应。和MD可以成功预测对MPP的响应，它们的组合可以进一步改善预测响应的准确性。

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《Journal of Clinical Ultrasound: JCU》 |2019年第6期|共10页
作者
Zhu Mengruo; Chen Haiyan; Fulati Zibire; Liu Yang; Su Yangang; Shu Xianhong;
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作者单位

Fudan Univ Zhongshan Hosp Dept Echocardiog 180 Fenglin Rd Shanghai 200032 Peoples R China;

Fudan Univ Zhongshan Hosp Dept Echocardiog 180 Fenglin Rd Shanghai 200032 Peoples R China;

Fudan Univ Zhongshan Hosp Dept Echocardiog 180 Fenglin Rd Shanghai 200032 Peoples R China;

Fudan Univ Zhongshan Hosp Dept Echocardiog 180 Fenglin Rd Shanghai 200032 Peoples R China;

Fudan Univ Zhongshan Hosp Dept Cardiol Shanghai Peoples R China;

Fudan Univ Zhongshan Hosp Dept Echocardiog 180 Fenglin Rd Shanghai 200032 Peoples R China;

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正文语种 eng
中图分类影像诊断学;
关键词
cardiac resynchronization therapy; dyssynchrony; echocardiography; multipoint pacing; strain;

机译：心脏重新同步疗法;Dyssyncochrony;超声心动图;多点起搏;应变;

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1. Left ventricular global longitudinal strain and mechanical dispersion predict response to multipoint pacing for cardiac resynchronization therapy [J] . Zhu Mengruo, Chen Haiyan, Fulati Zibire, Journal of Clinical Ultrasound: JCU . 2019,第6期

机译：左心室全局纵向应变和机械分散性预测心脏重新同步治疗的多点起搏的反应
2. Multipoint pacing via a quadripolar left-ventricular lead: preliminary results from the Italian registry on multipoint left-ventricular pacing in cardiac resynchronization therapy (IRON-MPP) [J] . Forleo Giovanni B., Santini Luca, Giammaria Massimo, Europace: European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology . 2017,第7期

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3. Optimization of left ventricular pacing site plus multipoint pacing improves remodeling and clinical response to cardiac resynchronization therapy at 1 year [J] . Zanon Francesco, Marcantoni Lina, Baracca Enrico, Heart rhythm: the official journal of the Heart Rhythm Society . 2016,第8期

机译：优化左心室起搏部位加多点起搏可改善1年时对心脏再同步治疗的重塑和临床反应
4. Evaluation of Short-Term Pacing Effect to Predict Long-Term Response to Cardiac Resynchronization Therapy: the TRAJECTORIES Study [C] . Giulia Santarelli, Roberta Ciccotelli, Giulio Molon, Computing in Cardiology Conference . 2019

机译：短期起搏作用的评估，以预测对心脏再同步治疗的长期反应：TRAJECTORIES研究
5. Electromechanical Wave Imaging in the Clinic: Localization of Atrial and Ventricular Arrhythmias and Quantification of Cardiac Resynchronization Therapy Response [D] . ?Melki, Lea 2020

机译：临床中的机电波成像：心房和心间心律失常的定位和心脏重新同步治疗反应的定量
6. Multipoint pacing via a quadripolar left-ventricular lead: preliminary results from the Italian registry on multipoint left-ventricular pacing in cardiac resynchronization therapy (IRON-MPP) [O] . Giovanni B. Forleo, Luca Santini, Massimo Giammaria, -1

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Left ventricular global longitudinal strain and mechanical dispersion predict response to multipoint pacing for cardiac resynchronization therapy

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