Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Background: Cardiac resynchronization therapy (CRT) is a well-established treatment in selected patients with drug-refractory heart failure. In order to improve the response rate of patients treated with CRT, imaging can provide information on mechanical dyssynchrony, viability, and cardiac venous anatomy. Two-dimensional speckle tracking imaging, a new echocardiographic method could be useful in assessing dyssynchrony and regional contractility. Aim of the work: the aim of the present study was to evaluate the ability of longitudinal strain and strain rate imaging by two-dimensional speckle tracking to predict echocardiographic response under CRT. Subjects and Methods: We studied 28 consecutive CRT patients with class II-IV heart failure, ejection fraction (EF) {u2264}35%, with LBBB and QRS with {u2265}120 ms or non LBBB with QRS {u2265}150 ms. baseline dyssynchrony was evaluated by speckle tracking longitudinal strain. Pre-specified outcome variables were EF response, reverse remodeling, 6 MWTs improvement and quality of life questionnaire in the following 3 months. Results: After 3 month follow up patients one patient was excluded as he died before he completed 3 months follow up period then the pts were divided into 19 pts (70%) responders and 8 pts (29.6%) non-responders according reduction of LVESV by {u2265}15%.

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