A1 Refereed original research article in a scientific journal

Association between echocardiography-derived haemodynamic force parameters and left ventricular reverse remodelling after cardiac resynchronization therapy




AuthorsLaenens, Dorien; van der Bijl, Pieter; Galloo, Xavier; Rossi, Alessandro C; Tonti, Giovanni; Reiber, Johan H C; Pedrizzetti, Gianni; Ajmone Marsan, Nina; Bax, Jeroen J

PublisherOxford University Press

Publication year2024

JournalEHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging

Journal name in sourceEuropean heart journal. Cardiovascular Imaging

Journal acronymEur Heart J Cardiovasc Imaging

Volume25

Issue12

First page 1721

Last page1733

ISSN2047-2404

eISSN2047-2412

DOIhttps://doi.org/10.1093/ehjci/jeae181

Web address https://academic.oup.com/ehjcimaging/advance-article/doi/10.1093/ehjci/jeae181/7715806

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/457267220


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: 1)apical-basal (AB) strength, 2)lateral-septal strength, 3)force vector angle, 4)systolic AB impulse, 5)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.


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Funding information in the publication
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.


Last updated on 2025-28-02 at 08:55