Heart failureUsefulness of Three-Dimensional Speckle Tracking Strain to Quantify Dyssynchrony and the Site of Latest Mechanical Activation
Section snippets
Methods
The study group consisted of 67 subjects, 57 patients with HF referred for CRT and 10 healthy volunteers as normal controls. This protocol was approved by the institutional review board on biomedical research and all subjects gave informed consent consistent with this protocol. The study group consisted of 54 patients with HF after 3 (5%) were excluded from analysis because of poor echocardiographic windows. All patients had HF functional class III, with an ejection fraction (EF) ≤35% and QRS
Results
Overall, 3-D speckle tracking radial dyssynchrony analysis was possible in 963 of 1,024 attempted segments (94%) from the 64 subjects with overall technically adequate images. The total time for 3-D speckle tracking dyssynchrony analysis was approximately 4 to 7 minutes per patient. As expected, 3-D speckle tracking dyssynchrony in patients with HF was significantly greater than that in controls (maximal opposing wall delay 316 ± 112 vs 59 ± 12 ms and SD 124 ± 48 vs 28 ± 11 ms, p <0.001 vs
Discussion
This is the first study to use a novel 3-D speckle tracking echocardiographic system to quantify LV dyssynchrony and site of latest mechanical activation. The 3-D speckle tracking radial strain was feasible in the large majority of consecutive patients studied. It quantified dyssynchrony in patients on CRT to be significantly greater than that in controls, as expected. There was a close correlation between the 2-D– and 3-D–derived speckle tracking radial dyssynchrony indexes. In addition, the
Acknowledgment
The authors are grateful for the support of the entire staff of the echocardiography and electrophysiology laboratories of the University of Pittsburgh Presbyterian University Hospital, Pittsburgh, Pennsylvania.
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This study was supported in part by National Heart, Lung, and Blood Institute Award 2 K24 HL004503-06 from the National Institutes of Health, Bethesda, Maryland, and a research grant from Toshiba Medical Corporation, Tokyo, Japan.