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Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines.

Publication ,  Journal Article
Zweerink, A; Friedman, DJ; Klem, I; van de Ven, PM; Vink, C; Biesbroek, PS; Hansen, SM; Kim, RJ; van Rossum, AC; Atwater, BD; Allaart, CP; Nijveldt, R
Published in: Circ Cardiovasc Imaging
July 2021

BACKGROUND: Patients with a class I recommendation for cardiac resynchronization therapy (CRT) are likely to benefit, but the effect of CRT in class II patients is more heterogeneous and additional selection parameters are needed in this group. The recently validated segment length in cine strain analysis of the septum (SLICE-ESSsep) measurement on cardiac magnetic resonance cine imaging predicts left ventricular functional recovery after CRT but its prognostic value is unknown. This study sought to evaluate the prognostic value of SLICE-ESSsep for clinical outcome after CRT. METHODS: Two hundred eighteen patients with a left bundle branch block or intraventricular conduction delay and a class I or class II indication for CRT who underwent preimplantation cardiovascular magnetic resonance examination were enrolled. SLICE-ESSsep was manually measured on standard cardiovascular magnetic resonance cine imaging. The primary combined end point was all-cause mortality, left ventricular assist device, or heart transplantation. Secondary end points were (1) appropriate implantable cardioverter defibrillator therapy and (2) heart failure hospitalization. RESULTS: Two-thirds (65%) of patients had a positive SLICE-ESSsep ≥0.9% (ie, systolic septal stretching). During a median follow-up of 3.8 years, 66 (30%) patients reached the primary end point. Patients with positive SLICE-ESSsep were at lower risk to reach the primary end point (hazard ratio 0.36; P<0.001) and heart failure hospitalization (hazard ratio 0.41; P=0.019), but not for implantable cardioverter defibrillator therapy (hazard ratio, 0.66; P=0.272). Clinical outcome of class II patients with a positive ESSsep was similar to those of class I patients (hazard ratio, 1.38 [95% CI, 0.66-2.88]; P=0.396). CONCLUSIONS: Strain assessment of the septum (SLICE-ESSsep) provides a prognostic measure for clinical outcome after CRT. Detection of a positive SLICE-ESSsep in patients with a class II indication predicts improved CRT outcome similar to those with a class I indication whereas SLICE-ESSsep negative patients have poor prognosis after CRT implantation.

Duke Scholars

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Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

July 2021

Volume

14

Issue

7

Start / End Page

e012350

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Retreatment
  • Recovery of Function
  • Predictive Value of Tests
  • Practice Guidelines as Topic
  • Patient Selection
  • North Carolina
  • Netherlands
  • Myocardium
 

Citation

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ICMJE
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Zweerink, A., Friedman, D. J., Klem, I., van de Ven, P. M., Vink, C., Biesbroek, P. S., … Nijveldt, R. (2021). Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines. Circ Cardiovasc Imaging, 14(7), e012350. https://doi.org/10.1161/CIRCIMAGING.120.012350
Zweerink, Alwin, Daniel J. Friedman, Igor Klem, Peter M. van de Ven, Caitlin Vink, P Stefan Biesbroek, Steen M. Hansen, et al. “Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines.Circ Cardiovasc Imaging 14, no. 7 (July 2021): e012350. https://doi.org/10.1161/CIRCIMAGING.120.012350.
Zweerink A, Friedman DJ, Klem I, van de Ven PM, Vink C, Biesbroek PS, et al. Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines. Circ Cardiovasc Imaging. 2021 Jul;14(7):e012350.
Zweerink, Alwin, et al. “Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines.Circ Cardiovasc Imaging, vol. 14, no. 7, July 2021, p. e012350. Pubmed, doi:10.1161/CIRCIMAGING.120.012350.
Zweerink A, Friedman DJ, Klem I, van de Ven PM, Vink C, Biesbroek PS, Hansen SM, Kim RJ, van Rossum AC, Atwater BD, Allaart CP, Nijveldt R. Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines. Circ Cardiovasc Imaging. 2021 Jul;14(7):e012350.

Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

July 2021

Volume

14

Issue

7

Start / End Page

e012350

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Retreatment
  • Recovery of Function
  • Predictive Value of Tests
  • Practice Guidelines as Topic
  • Patient Selection
  • North Carolina
  • Netherlands
  • Myocardium