Echo/Doppler-derived time intervals are able to predict left ventricular reverse remodeling after cardiac resynchronization therapy

Cristina M. Porciani, Alessio Lilli, Francesco Cappelli, Alessia Pappone, Alessandro Paoletti Perini, Paolo Pieragnoli, Giuseppe Ricciardi, Carmelo M. Rao, Frits W. Prinzen, Antonio Michelucci, Luigi Padeletti

Research output: Contribution to journalArticle

Abstract

Aim: We evaluated the predictive value of echo/Doppler derived indices, which reflect the duration of the isovolumic phases of the cardiac cycle, in identifying cardiac resynchronization therapy (CRT) responders. Methods and Results: In 105 patients before and 6 months after CRT the following echo/Doppler parameters were evaluated: myocardial performance index (MPI) as the sum of isovolumic contraction time (IVCT) and isovolumic relaxation time (IVRT) divided by ejection time; total isovolumic time (t-IVT) as the sum of IVCT and IVRT divided by the RR interval; and standard deviation of the time to systolic peak velocity (Ts-SD) as asynchrony index. After 6 months, patients were defined responders according to 15% left ventricle (LV) end-systolic volume reduction or more. At baseline, responders (53.3%) had higher t-IVT and MPI than nonresponders (0.30 ± 0.06 versus 0.22 ± 0.05, P <0.0001 and 1.01 ± 0.27 versus 0.73 ± 0.19, P <0.0001, respectively). Receiving operating characteristic curve analysis showed that both t-IVT (80.3% sensitivity and 83.7% specificity, cut-off = 0.263) and MPI (78.6% sensitivity and 81.6% specificity, cut-off = 0.84) could predict CRT response. Baseline t-IVT correlated well to end-systolic volume reduction (r = -0.56, P <0.00001). Conclusion: Echo/Doppler derived indices, describing physiologic abnormalities of the isovolumic contraction and relaxation phase, are able to predict CRT-induced reverse remodeling.

Original languageEnglish
Pages (from-to)157-163
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume11
Issue number3
DOIs
Publication statusPublished - Mar 2010

Keywords

  • Cardiac resynchronization therapy
  • Isovolumic time
  • Reverse remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Porciani, C. M., Lilli, A., Cappelli, F., Pappone, A., Perini, A. P., Pieragnoli, P., Ricciardi, G., Rao, C. M., Prinzen, F. W., Michelucci, A., & Padeletti, L. (2010). Echo/Doppler-derived time intervals are able to predict left ventricular reverse remodeling after cardiac resynchronization therapy. Journal of Cardiovascular Medicine, 11(3), 157-163. https://doi.org/10.2459/JCM.0b013e328332e938