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
Authors: Laenens, Dorien; van der Bijl, Pieter; Galloo, Xavier; Rossi, Alessandro C; Tonti, Giovanni; Reiber, Johan H C; Pedrizzetti, Gianni; Ajmone Marsan, Nina; Bax, Jeroen J
Publisher: Oxford University Press
Publication year: 2024
Journal: EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging
Journal name in source: European heart journal. Cardiovascular Imaging
Journal acronym: Eur Heart J Cardiovasc Imaging
Volume: 25
Issue: 12
First page : 1721
Last page: 1733
ISSN: 2047-2404
eISSN: 2047-2412
DOI: https://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 address: https://research.utu.fi/converis/portal/detail/Publication/457267220
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.