Association between echocardiography-derived haemodynamic force parameters and left ventricular reverse remodelling after cardiac resynchronization therapy.
Dorien Laenens, Pieter van der Bijl, Xavier Galloo, Alessandro C Rossi, Giovanni Tonti, Johan H C Reiber, Gianni Pedrizzetti, Nina Ajmone Marsan, Jeroen J Bax
{"title":"Association between echocardiography-derived haemodynamic force parameters and left ventricular reverse remodelling after cardiac resynchronization therapy.","authors":"Dorien Laenens, Pieter van der Bijl, Xavier Galloo, Alessandro C Rossi, Giovanni Tonti, Johan H C Reiber, Gianni Pedrizzetti, Nina Ajmone Marsan, Jeroen J Bax","doi":"10.1093/ehjci/jeae181","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Cardiac resynchronization therapy (CRT) may induce left ventricular (LV) reverse remodelling (=LV response) in patients with heart failure. Intraventricular pressure gradients can be quantified using echocardiography-derived haemodynamic forces (HDF). The aim was to evaluate the association between baseline HDF and LV response and to compare the change of HDF after CRT between LV responders and LV non-responders.</p><p><strong>Methods and results: </strong>The following HDF parameters were assessed: (i) apical-basal (AB) strength, (ii) lateral-septal strength, (iii) force vector angle, (iv) systolic AB impulse, (v) systolic force vector angle. LV response was defined as a reduction of LV end-systolic volume ≥ 15% at six months. One hundred ninety-six patients were included [64 ± 11 years, 122 (62%) men], 136 (69%) showed LV response. On multivariable logistic regression analysis, the force vector angle in the complete heart cycle [OR 1.083 (95% CI: 1.018, 1.153), P = 0.012] and the systolic force vector angle [OR 1.089 (95% CI: 1.021, 1.161), P = 0.009], both included in separate models, were independently associated with LV response. Six months after CRT, LV responders had greater AB strength, AB impulse, and higher force vector angles, while LV non-responders only showed improvement in the force vector angle in the complete heart cycle.</p><p><strong>Conclusion: </strong>The orientation of HDF at baseline is associated with LV response to CRT. Six months after CRT, the orientation of HDF improves in LV responders and LV non-responders, while the magnitude of AB HDF only improves in LV responders.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"1721-1733"},"PeriodicalIF":6.7000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601885/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjci/jeae181","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: Cardiac resynchronization therapy (CRT) may induce left ventricular (LV) reverse remodelling (=LV response) in patients with heart failure. Intraventricular pressure gradients can be quantified using echocardiography-derived haemodynamic forces (HDF). The aim was to evaluate the association between baseline HDF and LV response and to compare the change of HDF after CRT between LV responders and LV non-responders.
Methods and results: The following HDF parameters were assessed: (i) apical-basal (AB) strength, (ii) lateral-septal strength, (iii) force vector angle, (iv) systolic AB impulse, (v) systolic force vector angle. LV response was defined as a reduction of LV end-systolic volume ≥ 15% at six months. One hundred ninety-six patients were included [64 ± 11 years, 122 (62%) men], 136 (69%) showed LV response. On multivariable logistic regression analysis, the force vector angle in the complete heart cycle [OR 1.083 (95% CI: 1.018, 1.153), P = 0.012] and the systolic force vector angle [OR 1.089 (95% CI: 1.021, 1.161), P = 0.009], both included in separate models, were independently associated with LV response. Six months after CRT, LV responders had greater AB strength, AB impulse, and higher force vector angles, while LV non-responders only showed improvement in the force vector angle in the complete heart cycle.
Conclusion: The orientation of HDF at baseline is associated with LV response to CRT. Six months after CRT, the orientation of HDF improves in LV responders and LV non-responders, while the magnitude of AB HDF only improves in LV responders.
期刊介绍:
European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology.
The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.