Evaluating the predictive efficacy of real-time 3D echocardiography in cardiac resynchronization therapy.

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-10-01 DOI:10.1186/s13019-024-03058-2
Zhong-Yin Zhou, Jian-Xiang Zhu, Dong-Sheng Zhao, Bing-Qian Ding, Jia-Ling Wang, Gang Lin
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Abstract

Background: The aim of this study is to assess the predictive efficacy of real-time three-dimensional echocardiography (RT-3DE) and QRS wave duration in determining the response to cardiac resynchronization therapy (CRT) and assessing left ventricular systolic function pre- and post-CRT device implantation.

Method: A total of 51 patients with heart failure undergoing CRT at the Second Affiliated Hospital of Nantong University between January 1, 2013, and October 31, 2020, were enrolled in this study. Traditional two-dimensional echocardiography and RT-3DE were performed pre and post-CRT, with QRS wave width data from electrocardiograms and additional clinical information collected. Patients were categorized into CRT responder (n = 36) and CRT non-responder (n = 15) groups based on their response to CRT device implantation. Comparative analyses were conducted on the general characteristics of both groups, as well as the predictive efficacy of RT-3DE and QRS wave width for CRT responsiveness and left ventricular systolic function. Data on the standard deviation (Tmsv16-SD, Tmsv12-SD, Tmsv6-SD) and maximum difference (Tmsv16-Dif, Tmsv12-Dif, Tmsv6-Dif) of left ventricular end-systolic volume (LVESV) at segments 16, 12, and 6, as well as QRS wave width, were collected and analyzed.

Results: The indicators Tmsv6-Dif, Tmsv12-Dif, Tmsv16-Dif, Tmsv6-SD, Tmsv12-SD, Tmsv16-SD, and QRS wave width exhibited significantly higher values in the CRT responder group when compared to the CRT non-responder group (P < 0.05). Among these, Tmsv16-SD demonstrated superior predictive performance for post-CRT response, with a sensitivity of 88.9%, specificity of 80.0%, and a diagnostic cut-off value of 6.19%. This predictive capability exceeded that of the conventional indicator, QRS wave width.

Conclusion: RT-3DE enables accurate prediction of post-CRT patient response and significantly facilitates quantitative assessment of CRT therapy efficacy.

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评估实时三维超声心动图在心脏再同步化治疗中的预测效果。
研究背景本研究旨在评估实时三维超声心动图(RT-3DE)和QRS波持续时间在确定心脏再同步化治疗(CRT)反应和评估CRT装置植入前后左室收缩功能方面的预测效果:方法:南通大学附属第二医院在2013年1月1日至2020年10月31日期间共纳入51例接受CRT治疗的心衰患者。CRT前后均进行了传统的二维超声心动图和RT-3DE检查,并收集了心电图的QRS波宽度数据和其他临床信息。根据患者对植入 CRT 设备的反应,将其分为 CRT 反应者组(36 人)和 CRT 非反应者组(15 人)。对两组患者的一般特征以及RT-3DE和QRS波宽度对CRT反应性和左心室收缩功能的预测效果进行了比较分析。收集并分析了第 16、12 和 6 段左心室收缩末期容积(LVESV)的标准差(Tmsv16-SD、Tmsv12-SD、Tmsv6-SD)和最大差值(Tmsv16-Dif、Tmsv12-Dif、Tmsv6-Dif)以及 QRS 波宽度的数据:结果:与 CRT 非应答组相比,CRT 应答组的 Tmsv6-Dif、Tmsv12-Dif、Tmsv16-Dif、Tmsv6-SD、Tmsv12-SD、Tmsv16-SD 和 QRS 波宽度等指标的值均显著升高(P 结论:RT-3DE 能够准确预测 CRT 后的心律失常:RT-3DE 能够准确预测 CRT 后患者的反应,并极大地促进了对 CRT 疗效的定量评估。
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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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