Evaluation of Cardiac Function & Dyssynchrony in Patients Undergoing Cardiac Resynchronization Therapy Using Speckle Tracking Technique
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Since approval of Food & drug administration (FDA) on Cardiac resynchronization therapy (CRT) in 2001, CRT become one of the mainstay in treatment of patients with heart failure and left bundle branch Block (LBBB). Hence ; specific echocardiographic parameters is mandatory to identify patients who did respond and those who didn’t respond to CRT and to extent of linking baseline Dyssynchrony parameters & risk factors history of Ischemic Heart Disease & diabetes with their response. The aim of this study is to identify the role of Longitudinal strain & Dyssynchrony parameters in three months follow up of patients with CRT. Study Population: eighteen patients with symptomatic Heart Failure with symptomatic Heart failure & New York Heart Association functional classification (NYHA) class II or IV symptoms, all patients included in this Study were with Sinus rhythm, prolonged QRS >120 milliseconds & their Left ventricular EF < 35%. All patients treated with CRT in Cardiology Unit, Baghdad Teaching Hospital, Medical City, Baghdad-Iraq. Method: in this Before & After study, different methods for Evaluation of ventricular synchrony were used, Both Convectional Echocardiography for Dyssynchrony parameters, ejection fraction (%) & Longitudinal Stain Imaging using Speckle tracking were made to all patients at Baseline and three months after implantation of CRT. Results: at three months, all patients show significant improvement in EF% from 26.02(2.8) to 36.94(8.32) (p0.014), SPWMD from (206.27±47.30) to (37.89±7.56) (p0.023), IVMD from (48.33±17.04) to (25.77±7.00) (p 0.002), while GLS show non-significant change (p0.16). Conclusion, conventional synchrony parameter not enough to predict cardiac future remodeling, Longitudinal Strain is useful tool to identify early cardiac remodeling before being clinically significant.
Authors and Affiliations
Affan Ezzat Hasan, Fahad Abbas Abdul Rahman, Ghazi Farhan Haji, Ghassan Mohammed Mahmoud
Keywords
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