Usefulness of echocardiographic tissue synchronization imaging to predict acute response to cardiac resynchronization therapy

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Abstract

Echocardiographic tissue synchronization imaging (TSI) consists of color-coding time-to-peak tissue Doppler velocities. This study of 29 patients who underwent cardiac resynchronization therapy (CRT) demonstrated that differences in baseline time-to-speak velocities of opposing ventricular walls by TSI were greater in 15 patients, with an acute hemodynamic improvement. A ≥65 ms delay from the anterior septum to the posterior wall using the apical long-axis view had 87% sensitivity and 100% specificity for predicting an acute response. Although a subgroup without acute improvement had later decreases in end-systolic volume, suggesting that acute response underestimates long-term effects, TSI has potential to assist in guiding CRT.

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Acknowledgements

We thank Andreas Heimdal, PhD, and the GE-Vingmed Corporation for creation of the TSI software; Thaddeus Chodakauskas, BS, RDMS, for technical support; and Leonard I. Ganz, MD, Samir F. Saba, MD, and William Barrington, MD, for their clinical expertise and cooperation.

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Dr. Gorcsan was supported in part by award K24 HL04503-01 from the National Institutes of Health, Bethesda, Maryland and the National grant-in-aid 0050587N from the American Heart Association, Dallas, Texas.

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