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Evaluation of Response to Cardiac Resynchronization Therapy in Patients with Non-Ischemic Cardiomyopathy Based on Echocardiographic Features Including Sphericity Index and Global Longitudinal Strain

AUTHORS

avatar Roja Valipoor ORCID 1 , avatar Masoud Eslami ORCID 1 , avatar Roya Sattarzadeh-Badkoubeh ORCID 1 , avatar Elnaz Shahmohamadi ORCID 2 , avatar Mehdi Rezaei ORCID 3 , avatar Reza Mollazadeh ORCID 1 , *

1 Department of Cardiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran

2 School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran

3 Department of Cardiology, Fars-Iranian Heart Association, Fars Society of Internal Medicine, Shiraz IR Iran

How to Cite: Valipoor R, Eslami M, Sattarzadeh-Badkoubeh R, Shahmohamadi E, Rezaei M, et al. Evaluation of Response to Cardiac Resynchronization Therapy in Patients with Non-Ischemic Cardiomyopathy Based on Echocardiographic Features Including Sphericity Index and Global Longitudinal Strain. Int Cardio Res J. 2021;15(2):e114876.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 15 (2); e114876
Published Online: June 30, 2021
Article Type: Research Article
Received: March 26, 2020
Revised: June 06, 2021
Accepted: June 19, 2021
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Abstract

Background: In patients with Non-Ischemic Cardiomyopathy (NICM), Cardiac
Resynchronization Therapy (CRT) has been shown to improve Left Ventricular Ejection
Fraction (LVEF) and NYHA functional class. However, in some patients who received
CRT, the results were not satisfying.
Objectives: This study aimed to evaluate echocardiographic features as a predictor of
positive response to CRT in patients with NICM.
Methods: This case series study was conducted on 11 consecutive patients with NICM
who were eligible for CRT at Imam Khomeini Hospital Complex. The patients’ basic
demographic and echocardiographic data including Septal Flash (SF), Sphericity
Index (SI), and Global Longitudinal Strain (GLS) were recorded and followed for six
months. Data analysis was done using the SPSS software, and paired t-test was used for
comparison of the study variables.
Results: The results revealed an improvement in the median NYHA functional class
from 3 (interquartile range: 2 - 4) to 1 (interquartile range: 1 - 2) (P < 0.001) at the
follow-up. Assessment of LVEF through the Simpson method also showed a significant
improvement from 28.25% to 39.31% (P < 0.001). Moreover, GLS improved and SI and SF
decreased post CRT implantation.
Conclusions: The results demonstrated that a GLS of less than -10.48 before device
implantation, but not SI or SF, might be a predictor of a positive response to CRT in
patients with NICM. In these patients, higher GLS at baseline might add data to the
existing criteria for selecting suitable patients for CRT implantation.

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© 2021, Shiraz University of Medical Sciences.
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