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

Roja Valipoor; Masoud Eslami; Roya Sattarzadeh-Badkoubeh; Elnaz Shahmohamadi; Mehdi Rezaei; Reza Mollazadeh

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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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

Author(s):

Roja Valipoor

¹,

Masoud Eslami

¹,

Roya Sattarzadeh-Badkoubeh

¹,

Elnaz Shahmohamadi

²,

Mehdi Rezaei

³,

Reza Mollazadeh

^1,*

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

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

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

International Cardiovascular Research Journal:Vol. 15, issue 2; e114876

Published online:Jun 30, 2021

Article type:Research Article

Received:Mar 26, 2020

Accepted:Jun 19, 2021

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 Cardiovasc Res J.2021;15(2):e114876.

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.

Keywords

Sphericity index

Cardiac Resynchronization Therapy

Echocardiography

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