TY - JOUR
T1 - The role of tissue Doppler and strain imaging in predicting response to CRT.
AU - Gorcsan, John
AU - Suffoletto, Matthew S.
PY - 2008/11
Y1 - 2008/11
N2 - AIMS: Several echocardiographic methods have been proposed to assist in patient selection for cardiac resynchronization therapy (CRT). The prevailing hypothesis is that echocardiography may be superior to the electrocardiogram to qualify abnormalities in regional mechanical activation, because QRS widening is only a surrogate for ventricular dyssynchrony. METHODS AND RESULTS: This review will focus on tissue Doppler (TD) and strain imaging, including their advantages and disadvantages for patient selection for CRT. Colour-coded TD remains to be one of the most promising means to quantify dyssynchrony. Tissue Doppler velocity data have a more favourable signal-to-noise ratio compared with TD strain or strain rate imaging. However, velocity data are affected by Doppler angle of incidence and passive or tethering motion. A newer promising method is speckle-tracking echocardiography to calculate strain. An opposing wall delay in peak TD velocity > or =65 ms has been associated with clinical and ventricular response to CRT. The initial experience with speckle tracking used the short-axis view to calculate radial strain. An anterior-septal to posterior wall peak strain delay > or =130 ms has been associated with an ejection fraction response to CRT. CONCLUSION: Although no ideal echo-Doppler method has yet been discovered to select patients for CRT, technical refinements and advances in understanding of pathophysiology continue to favourably impact on potential clinical applications.
AB - AIMS: Several echocardiographic methods have been proposed to assist in patient selection for cardiac resynchronization therapy (CRT). The prevailing hypothesis is that echocardiography may be superior to the electrocardiogram to qualify abnormalities in regional mechanical activation, because QRS widening is only a surrogate for ventricular dyssynchrony. METHODS AND RESULTS: This review will focus on tissue Doppler (TD) and strain imaging, including their advantages and disadvantages for patient selection for CRT. Colour-coded TD remains to be one of the most promising means to quantify dyssynchrony. Tissue Doppler velocity data have a more favourable signal-to-noise ratio compared with TD strain or strain rate imaging. However, velocity data are affected by Doppler angle of incidence and passive or tethering motion. A newer promising method is speckle-tracking echocardiography to calculate strain. An opposing wall delay in peak TD velocity > or =65 ms has been associated with clinical and ventricular response to CRT. The initial experience with speckle tracking used the short-axis view to calculate radial strain. An anterior-septal to posterior wall peak strain delay > or =130 ms has been associated with an ejection fraction response to CRT. CONCLUSION: Although no ideal echo-Doppler method has yet been discovered to select patients for CRT, technical refinements and advances in understanding of pathophysiology continue to favourably impact on potential clinical applications.
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U2 - 10.1093/europace/eun222
DO - 10.1093/europace/eun222
M3 - Review article
C2 - 18955405
AN - SCOPUS:59649118704
SN - 1099-5129
VL - 10 Suppl 3
SP - iii80-87
JO - Europace
JF - Europace
ER -