Роль двухмерной деформации speckle tracking в определении предикторов ответа на сердечную ресинхронизирующую терапию у больных с хронической сердечной недостаточностью различной этиологии

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Abstract

Objective. To define the predictors of response to cardiac resynchronizationtherapy in patients with chronic cardiac failure, using speckle tracking — the method of two-dimensional deformation.

Material and methods. 40 patients with heart failure (HF) were included in the study: 15 patients were with chronic cardiac failure (CCF) and ischemic cardiomyopathy (ICM), 25 patients were with CCF with idiopathic dilated cardiomyopathy (DCM). Mean age of patients was 61.73±10.4 years. Medium left ventricular ejection fraction n (LVEF) was 34.66±12.55%. Average duration of QRS was 159±30 ms. Patients were in NYHA FC II–IV. They initially had total left bunch branch block (TLBBB). The devices for cardiac resynchronization therapy (CRT) and cardiac resynchronization therapy with defibrillation f unction (CRT-D) were implanted to all patients. The results were analyzed within a year after implantation of biventricular stimulator (BVS).

References

1. Ansalone G., Giannantoni P., Ricci R. et al. Doppler myocardial imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing // J. Am. Coll. Cardiol. 2002. Vol. 39. P. 489–499.

2. Bax J. J., Bleeker G. B., Marwick T. H. et al. Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy // J. Am. Coll. Cardiol. 2004. Vol. 44. P. 1834–1840.

3. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement // Lancet. 1986. Vol. 1. P. 307–310.

4. Delgado V., Ypenburg C., van Bommel R. J. et al. Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy // J. Am. Coll. Cardiol. 2008. Vol. 51. P. 1944–1952.

5. Dohi K., Suffoletto M. S., Schwartzman D. et al. Utility of echocardiographic radial strain to quantify left ventricular dyssynchrony and predict acute response to cardiac resynchronization therapy // Am. J. Cardiol. 2005. Vol. 96. P. 112–116.

6. Gorcsan J., III, Kanzaki H., Bazaz R. et al. Usefulness of echocardiographic tissue synchro- nization imaging to predict acute response to cardiac resynchronization therapy // Am. J. Cardiol. 2004. Vol. 93. P. 1178–1181.

7. Gorcsan J., III, Tanabe M., Bleeker G. B. et al. Combined longitudinal and radial dyssynchrony predicts ventricular response after resynchronization therapy // J. Am. Coll. Cardiol. 2007. Vol. 50. P. 1476–1483.

8. Gregoratos G., Abrams J., Epstein A. E. et al. ACC/AHA/NASPE 2002 Guideline update for implantation of cardiac pacemakers and antiarrhythmia devices – summary article: a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines) // J. Am. Coll. Cardiol. 2002. Vol. 40. P. 1703–1719.

9. Hunt S. A., Abraham W. T., Chin M. H. et al. ACC/AHA 2005 Guideline update for the diagnosis and management of chronic heart failure in the adult: summary article: a Report from the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evolution and Management of Heart Failure) // J. Am. Coll. Cardiol. 2005. Vol. 46. P. 1116–1143.

10. Kanzaki H., Bazaz R., Schwartzman D. A mechanism for immediate reduction in mitral regurgitation following cardiac resynchronization therapy: insights from mechanical activation strain mapping // J. Am. Coll. Cardiol. 2004. Vol. 44. P. 1619–1625.

11. Kass D. A., Chen C. H., Curry C. et al. Improved left ventricular mechanics from acute VDD pacing in patients with dilated cardiomyopathy and ventricular conduction delay // Circulation. 1999. Vol. 99. P. 1567–1573.

12. Keogh A., Baron D., Hickie J. Prognostic guides in patients with idiopathic or ischemic dilated cardiomyopathy assessed for cardiac transplantation // Am. J. Cardiol. 1990. Vol. 65. P. 903–906.

13. Notomi Y., Lysyansky P., Setser R. M. et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging // J. Am. Coll. Cardiol. 2005. Vol. 45. P. 2034–2041.

14. Pitzalis M. V., Iacoviello M., Romito R. et al. Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony // J. Am. Coll. Cardiol. 2002. Vol. 40. P. 1615–1622.

15. Saxon L. A., Stevenson W. G., Middlekauff H. R. et al. Predicting death from progressive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy // Am. J. Cardiol. 1993. Vol. 72. P. 62– 65.

16. Sшgaard P., Egeblad H., Kim W. Y. et al. Tissue Doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy // J. Am. Coll. Cardiol. 2002. Vol. 40. P. 723–730.

17. Suffoletto M. S., Dohi K., Cannesson M. et al. Novel speckle-tracking radial strain from routine blackand- white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy // Circulation. 2006. Vol. 113. P. 960–968.

18. Yu C. M., Gorcsan J., III, Bleeker G. B. et al. Usefulness of tissue Doppler velocity and strain dyssynchrony for predicting left ventricular reverse remodeling response after cardiac resynchronization therapy // Am. J. Cardiol. 2007. Vol. 100. P. 1263–1270.

19. Yu C. M., Chau E., Sanderson J. E. et al. Tissue Doppler echocardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure // Circulation. 2002. Vol. 105. P. 438–445.

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery