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https://www.readbyqxmd.com/read/28075037/gauging-the-response-to-cardiac-resynchronization-therapy-the-important-interplay-between-predictor-variables-and-definition-of-a-favorable-outcome
#1
Milan Petrovic, Marija Petrovic, Goran Milasinovic, Bosiljka Vujisic Tesic, Danijela Trifunovic, Olga Petrovic, Ivana Nedeljkovic, Ivana Petrovic, Marko Banovic, Marija Boricic-Kostic, Jelena Petrovic, Ross Arena, Dejana Popovic
AIMS: Selection of patients who are viable candidates for cardiac resynchronization therapy (CRT), prediction of the response to CRT as well as an optimal definition of a favorable response, all require further exploration. The purpose of this study was to evaluate the interplay between the prediction of the response to CRT and the definition of a favorable outcome. METHODS: Seventy patients who received CRT were included. All patients met current guideline criteria for CRT...
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28067978/imaging-left-ventricular-mechanical-activation-in-heart-failure-patients-using-cine-dense-mri-validation-and-implications-for-cardiac-resynchronization-therapy
#2
Daniel A Auger, Kenneth C Bilchick, Jorge A Gonzalez, Sophia X Cui, Jeffrey W Holmes, Christopher M Kramer, Michael Salerno, Frederick H Epstein
PURPOSE: To image late mechanical activation and identify effective left-ventricular (LV) pacing sites for cardiac resynchronization therapy (CRT). There is variability in defining mechanical activation time, with some studies using the time to peak strain (TPS) and some using the time to the onset of circumferential shortening (TOS). We developed improved methods for imaging mechanical activation and evaluated them in heart failure (HF) patients undergoing CRT. MATERIALS AND METHODS: We applied active contours to cine displacement encoding with stimulated echoes (DENSE) strain images to detect TOS...
January 9, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28065448/left-ventricular-dyssynchrony-and-2d-and-3d-global-longitudinal-strain-for-differentiating-physiological-and-pathological-left-ventricular-hypertrophy
#3
Julien Ternacle, Camille Bremont, Thomas d'Humieres, Laureline Faivre, Huy Long Doan, Romain Gallet, Leopold Oliver, Jean-Luc Dubois-Randé, Pascal Lim
BACKGROUND: Diagnosis of hypertrophic cardiomyopathy (HCM) in athletes can be challenging. AIMS: To ascertain parameters that differentiate patients with HCM from athletes with moderate left ventricular (LV) hypertrophy (LVH 13-15mm). METHODS: We retrospectively included 100 men: 50 elite rugby players (25 with moderate LVH and 25 with no LVH), 25 patients with HCM and moderate LVH and 25 controls. LV dyssynchrony was defined as the standard deviation of time to peak 2D longitudinal strain (16-segment model) and global strain components were computed from two- (2D) and three-dimensional (3D) speckle tracking...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28065446/mechanical-dyssynchrony-in-heart-failure-still-a-valid-concept-for-optimizing-treatment
#4
REVIEW
Elena Galli, Christophe Leclercq, Erwan Donal
Cardiac resynchronization therapy (CRT) has had a major favourable impact on the care of patients with symptomatic heart failure, left ventricular ejection fraction<35% and enlarged QRS. Despite this, about 35% of patients who undergo CRT in accordance with current guidelines are "non-responders". Therefore, more accurate selection of CRT candidates would significantly improve patient benefit and decrease costs. In the past decade, some small non-randomized studies have shown that estimation of left ventricular dyssynchrony by echocardiography might be useful to ameliorate the selection of patients for CRT...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28063262/quantification-of-mechanical-dyssynchrony-in-growth-restricted-fetuses-and-normal-controls-using-speckle-tracking-echocardiography-ste
#5
Kristina Krause, Mareike Möllers, Kerstin Hammer, Maria Karina Falkenberg, Ute Möllmann, Dennis Görlich, Walter Klockenbusch, Ralf Schmitz
PURPOSE: To evaluate longitudinal mechanical dyssynchrony in normally grown fetuses by speckle tracking echocardiography (STE) and to compare longitudinal mechanical dyssynchrony in fetal growth restriction (FGR) with normal controls. MATERIALS AND METHODS: A prospective study was performed on 30 FGR and 62 normally grown fetuses, including 30 controls matched by gestational age, using STE and a transversal four-chamber view. Data analysis was carried out with a high frame rate of about 175 frames/s...
January 7, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28062704/radiosensitization-by-the-atr-inhibitor-azd6738-through-generation-of-acentric-micronuclei
#6
Magnus T Dillon, Holly E Barker, Malin Pedersen, Hind Hafsi, Shreerang A Bhide, Kate L Newbold, Christopher M Nutting, Martin McLaughlin, Kevin J Harrington
AZD6738 is an orally active ATR inhibitor (ATRi) currently in phase I clinical trials. We found in vitro growth inhibitory activity of this ATRi in a panel of human cancer cell lines. We demonstrated radiosensitization by AZD6738 to single radiation fractions in multiple cancer cell lines independent of both p53 and BRCA2 status by the clonogenic assay. Radiosensitization by AZD6738 to clinically relevant doses of fractionated radiation was demonstrated in vitro using a 3D tumor spheroid model and, in vivo, AZD6738 radiosensitized by abrogating the radiation-induced G2 cell-cycle checkpoint and inhibiting homologous recombination...
January 2017: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/28055859/right-ventricular-strain-torsion-and-dyssynchrony-in-healthy-subjects-using-3d-spiral-cine-dense-magnetic-resonance-imaging
#7
Jonathan Suever, Gregory Wehner, Linyuan Jing, David Powell, Sean Hamlet, Jonathan Grabau, Dimitri Mojsejenko, Kristin Andres, Christopher Haggerty, Brandon Fornwalt
Mechanics of the left ventricle (LV) are important indicators of cardiac function. The role of right ventricular (RV) mechanics is largely unknown due to the technical limitations of imaging its thin wall and complex geometry and motion. By combining 3D Displacement Encoding with Stimulated Echoes (DENSE) with a post-processing pipeline that includes a local coordinate system, it is possible to quantify RV strain, torsion, and synchrony. In this study, we sought to characterize RV mechanics in 50 healthy individuals and compare these values to their LV counterparts...
December 29, 2016: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28041955/cardiac-dysfunction-in-children-and-young-adults-with-heart-transplantation-a-comprehensive-echocardiography-study
#8
Marcello Chinali, Claudia Esposito, Giorgia Grutter, Roberta Iacobelli, Alessandra Toscano, Maria Grazia D'Asaro, Alessia Del Pasqua, Gianluca Brancaccio, Francesco Parisi, Fabrizio Drago, Gabriele Rinelli
BACKGROUND: Transplanted heart dysfunction is a serious life-threatening condition in pediatric transplant recipients. Several studies have focused on echocardiographic detection of early signs of cardiac dysfunction in this population. We evaluated advanced echocardiographic indices of cardiac function in a large sample of children and young adults with heart transplants with apparently normal cardiac function. METHODS: The study included 60 patients with normal ejection fraction with transplantation performed at pediatric age between 1986 and 2014 and 60 healthy control subjects...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28039208/clinical-significance-of-septal-deformation-patterns-in-heart-failure-patients-receiving-cardiac-resynchronization-therapy
#9
Aymeric Menet, Anne Bernard, Christophe Tribouilloy, Christophe Leclercq, Cécile Gevaert, Yves Guyomar, Raphaelle-Ashley Guerbaai, François Delelis, Anne-Laure Castel, Pierre Graux, Pierre-Vladimir Ennezat, Erwan Donal, Sylvestre Maréchaux
AIMS: Specific septal motion related to dyssynchrony is strongly linked to reverse remodelling, in patients with systolic heart failure (HF) receiving cardiac resynchronization therapy (CRT). We aimed to investigate the relationship between septal deformation patterns studied by longitudinal speckle tracking and clinical outcome following CRT. METHODS AND RESULTS: A total of 284 CRT candidates from two centres (HF NYHA classes II-IV, ejection fraction < 35%, QRS ≥ 120 ms) were prospectively included...
December 29, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28039201/why-septal-motion-is-a-marker-of-right-ventricular-failure-in-pulmonary-arterial-hypertension-mechanistic-analysis-using-a-computer-model
#10
Georgina Palau-Caballero, John Walmsley, Vanessa P M van Empel, Joost Lumens, Tammo Delhaas
BACKGROUND: Rapid leftward septal motion (RLSM) during early left ventricular diastole is observed in patients with pulmonary arterial hypertension (PAH). RLSM exacerbates right ventricular (RV) systolic dysfunction and impairs left ventricular (LV) filling. Increased RV wall tension caused by increased RV afterload has been suggested to cause interventricular relaxation dyssynchrony and RLSM in PAH. METHODS: Simulations using the CircAdapt computational model were used to unravel the mechanism underlying RLSM by mechanistically linking myocardial tissue and pump function...
December 30, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28025231/cardiac-resynchronization-therapy-by-multipoint-pacing-improves-response-of-left-ventricular-mechanics-and-fluid-dynamics-a-three-dimensional-and-particle-image-velocimetry-echo-study
#11
Mariachiara Siciliano, Federico Migliore, Luigi Badano, Emanuele Bertaglia, Gianni Pedrizzetti, Stefano Cavedon, Alessandro Zorzi, Domenico Corrado, Sabino Iliceto, Denisa Muraru
AIMS: To characterize the effect of multipoint pacing (MPP) compared to biventricular pacing (BiV) on left ventricle (LV) mechanics and intraventricular fluid dynamics by three-dimensional echocardiography (3DE) and echocardiographic particle imaging velocimetry (Echo-PIV). METHODS AND RESULTS: In 11 consecutive patients [8 men; median age 65 years (57-75)] receiving cardiac resynchronization therapy (CRT) with a quadripolar LV lead (Quartet,St.Jude Medical,Inc...
December 26, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28017393/long-term-outcome-after-crt-in-the-presence-of-mechanical-dyssynchrony-seen-with-chronic-rv-pacing-or-intrinsic-lbbb
#12
Ivan Stankovic, Christian Prinz, Agnieszka Ciarka, Ana Maria Daraban, Yujing Mo, Marit Aarones, Mariola Szulik, Stefan Winter, Aleksandar N Neskovic, Tomasz Kukulski, Svend Aakhus, Rik Willems, Wolfgang Fehske, Martin Penicka, Lothar Faber, Jens-Uwe Voigt
OBJECTIVES: The aim of this study was to compare the volumetric response and the long-term survival after cardiac resynchronization therapy (CRT) in patients with intrinsic left bundle branch block (LBBB) versus chronic right ventricular pacing (RVP) with respect to the presence of mechanical dyssynchrony (MD). BACKGROUND: Chronic RVP induces an iatrogenic LBBB and asynchronous left ventricular contraction that is potentially reversible by upgrading to CRT. METHODS: A total of 914 patients eligible for CRT (117 with conventional pacemakers and 797 with intrinsic LBBB) were included in the study...
December 9, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28012426/perceived-safety-and-efficacy-of-neuromuscular-blockers-for-acute-respiratory-distress-syndrome-among-medical-intensive-care-unit-practitioners-a-multicenter-survey
#13
Heather Torbic, Seth R Bauer, Heather A Personett, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Craig E Daniels, Sean M Caples, Erin N Frazee
PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013...
December 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28011837/non-invasive-model-based-measures-of-ventricular-electrical-dyssynchrony-for-predicting-crt-outcomes
#14
Christopher T Villongco, David E Krummen, Jeffrey H Omens, Andrew D McCulloch
AIMS: Left ventricular activation delay due to left bundle branch block (LBBB) is an important determinant of the severity of dyssynchronous heart failure (DHF). We investigated whether patient-specific computational models constructed from non-invasive measurements can provide measures of baseline dyssynchrony and its reduction after CRT that may explain the degree of long-term reverse ventricular remodelling. METHODS AND RESULTS: LV end-systolic volume reduction (ΔESVLV) measured by 2D trans-thoracic echocardiography in eight patients following 6 months of CRT was significantly (P < 0...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011802/novel-electrocardiographic-dyssynchrony-criteria-improve-patient-selection-for-cardiac-resynchronization-therapy
#15
András Vereckei, Zsuzsanna Szelényi, Valentina Kutyifa, Endre Zima, Gábor Szénási, Melinda Kiss, Gábor Katona, István Karádi, Béla Merkely
AIMS: We hypothesized that the greater the intra- or interventricular dyssynchrony (intraD, interD), the more effective cardiac resynchronization therapy (CRT) is. We sought to improve patient selection for CRT by using novel ECG dyssynchrony criteria. METHODS AND RESULTS: Left ventricular (LV) intraD was estimated by the absolute time difference between the intrinsicoid deflections (ID) in leads aVL and aVF divided by the QRS duration (QRSd): [aVLID - aVFID]/QRSd (%)...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27986357/interaction-of-left-ventricular-remodeling-and-regional-dyssynchrony-on-long-term-prognosis-after-cardiac-resynchronization-therapy
#16
Bhupendar Tayal, Peter Sogaard, Antonia Delgado-Montero, Akiko Goda, Samir Saba, Niels Risum, John Gorcsan
BACKGROUND: Left ventricular (LV) remodeling in heart failure (HF) manifested by chamber dilatation is associated with worse clinical outcomes. However, the impact of LV dilatation on the association of measures of dyssynchrony with long-term prognosis and resynchronization potential after cardiac resynchronization therapy (CRT) remains unclear. METHODS: Two hundred sixty CRT patients in New York Heart Association classes II to IV, with ejection fractions ≤ 35% and QRS intervals ≥ 120 msec, were prospectively studied...
December 13, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27958262/role-of-low%C3%A2-dose-dobutamine-echocardiography-in-predicting-response-to-biventricular-pacing-results-from-the%C3%A2-multicenter-viability-in-cardiac-resynchronisation-therapy-viacrt-study
#17
Edyta Płońska-Gościniak, Jarosław D Kasprzak, Tomasz Kukulski, Katarzyna Mizia-Stec, Ewa Nowalany-Kozielska, Zbigniew Gąsior, Krystian Wita, Władysław Sinkiewicz, Hanna Szwed, Piotr Gościniak, Łukasz Chrzanowski
INTRODUCTION    The response to Cardiac Resynchronisation Therapy (CRT) varies significantly, resulting in lack of improvement among the substantial patients proportion.  OBJECTIVES    To identify mechanical dyssynchrony indices with combination of myocardial viability characteristics for predicting long-term response to CRT.  PATIENTS AND METHODS    ViaCRT was a multicentre study coordinated by the Working Group on Echocardiography of  Polish Cardiac Society. 127 patients with heart failure were assessed prospectively...
December 12, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27956911/association-between-latest-activated-sites-in-the-left-ventricle-and-akinetic-segments-in-patients-with-ischemic-cardiomyopathy
#18
Hakimeh Sadeghian, Aliasghar Kousari, Shahla Majidi, Mehrnaz Rezvanfard, Ali Kazemisaeid, Seyed Ali Moezzi, Ali Vasheghani Farahani, Morteza Abdar Esfahani, Mohammad Sahebjam, Arezoo Zoroufian, Afsaneh Sadeghian
Background: It is not clear whether the latest activation sites in the left ventricle (LV) are matched with infracted regions in patients with ischemic cardiomyopathy (ICM). We aimed to investigate whether the latest activation sites in the LV are in agreement with the region of akinesia in patients with ICM. Methods: Data were analyzed in 106 patients (age = 60.5 ± 12.1 y, male = 88.7%) with ICM (ejection fraction ≤ 35%) who were refractory to pharmacological therapy and were referred to the echocardiography department for an evaluation of the feasibility of cardiac resynchronization therapy...
July 6, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27943062/longitudinal-function-and-ventricular-dyssynchrony-are-restored-in-children-with-pulmonary-stenosis-after-percutaneous-balloon-pulmonary-valvuloplasty
#19
Ragab A Mahfouz, Tamer M Moustafa, Mohammad Gouda, Marwa Gad
The aim of this study was to evaluate the impact of balloon pulmonary valvuloplasty on longitudinal ventricular dysfunction and cardiac dyssynchrony in children with congenital moderately severe pulmonary stenosis (PS). Forty-eight children with congenital moderately severe valvular pulmonary stenosis and 36 age-matched normal children were included. Successful percutaneous balloon pulmonary valvuloplasty was performed for children with PS. Longitudinal Cardiac function and myocardial synchrony was assessed by echocardiography with tissue Doppler imaging (TDI)...
December 10, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27920838/successful-resynchronization-by-permanent-his-bundle-pacing-in-a-patient-with-pacing-induced-cardiomyopathy
#20
Yoji Iida, Tomoaki Izawa, Chikara Kobari, Toru Yatsuhashi, Nobuyuki Makishima
Right ventricular (RV) pacing has been reported to result in ventricular dyssynchrony, heart failure, and increased mortality. Pacing associated deterioration of left ventricular (LV) systolic function has been termed pacing-induced cardiomyopathy (PICM). While upgrading to biventricular pacing (BiVP) is an effective therapy for PICM, permanent His-bundle pacing (HBP) can be a physiological alternative to BiVP. We present a patient with PICM who responded dramatically to permanent HBP.
December 2016: Journal of Arrhythmia
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