Baseline tissue Doppler imaging-derived echocardiographic parameters and left ventricle reverse remodelling following cardiac resynchronization therapy introduction

Introduction: The aim of the study was to assess the relation of baseline mechanical dyssynchrony with the left ventricular end-systolic volume (LVESV) decrease following cardiac resynchronization (CRT) therapy introduction. Material and methods: Sixty consecutive patients (aged 66.3 +/- 8.7 years; 57 men) with chronic heart failure (71.7% of ischaemic and 28.3% of non-ischaemic origin) and current indications for CRT were assessed before and 3 months after biventricular heart stimulator implantation. Longitudinal movements of twelve segments of the left ventricle (LV) (6 basal and 6 midlevel) and two segments of the right ventricle (RV) were analysed using tissue Doppler imaging (TDI) techniques with time from onset of Q wave in ECG to peak systolic velocity in colour-coded TDI (T-TDI), time to peak strain (T-strain) and time to peak strain rate (T-strain rate). Minimal and maximal time differences within LV and between LV and RV walls were calculated. Results: In the study group LVEF and 6-min walk test distance increased, while NYHA class, NT-proBNP level, left ventricular end-diastolic volume and LVESV decreased. Significant correlations between the magnitude of LVESV reduction with maximal time differences between T-strain of 12 LV segments (r = 0.34, p = 0.017) and time differences between T-TDI basal LV-RV segments (r = -0.29, p = 0.041) were found. Conclusions: Only a few TDI-derived parameters such as maximal time differences between T-strain of 12 LV segments and T-TDI difference of LV-RV basal segments can be useful to predict the magnitude of left ventricle reverse remodelling after CRT introduction.