The Speckle Tracking Imaging for the Assessment of Cardiac Resynchronization Therapy (START) Study

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  • Maruo Takeshi
    Department of Cardiology, Kurashiki Central Hospital
  • Seo Yoshihiro
    Cardiovascular Division, University of Tsukuba
  • Yamada Satoshi
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
  • Arita Takeshi
    Department of Cardiology, Kokura Memorial Hospital
  • Ishizu Tomoko
    Cardiovascular Division, University of Tsukuba
  • Shiga Tsuyoshi
    Department of Cardiology, Tokyo Women’s Medical University
  • Dohi Kaoru
    Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
  • Toide Hiroyuki
    Division of Cardiology, Gunma Prefectural Cardiovascular Center
  • Furugen Azusa
    Department of Cardiology, Tokyo Women’s Medical University
  • Inoue Katsuji
    Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
  • Daimon Masao
    Department of Cardiology, Juntendo University School of Medicine
  • Kawai Hiroya
    Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
  • Tsuruta Hikaru
    Department of Cardiology, Keio University School of Medicine
  • Nishigami Kazuhiro
    Department of Critical Care and Cardiology, Saiseikai Kumamoto Hospital
  • Yuda Satoshi
    Department of Clinical Laboratory Medicine, Sapporo Medical University School of Medicine
  • Ozawa Tomoya
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
  • Izumi Chisato
    Department of Cardiology, Tenri Hospital
  • Fumikura Yuko
    Department of Cardiology, Tsukuba Medical Center Hospital
  • Wada Yasuaki
    Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Doi Mariko
    Tsukuba Critical Path Research and Education Integrated Leading (CREIL) Center, University of Tsukuba
  • Okada Masafumi
    Tsukuba Critical Path Research and Education Integrated Leading (CREIL) Center, University of Tsukuba
  • Takenaka Katsu
    Department of Laboratory Medicine, The University of Tokyo Hospital
  • Aonuma Kazutaka
    Cardiovascular Division, University of Tsukuba

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Background:We sought to identify the feasibility of speckle tracking echocardiography (STE) to predict cardiac resynchronization therapy (CRT) responders in a prospective multicenter study.Methods and Results:Patients who were newly implanted with a CRT device were enrolled. Time (T) from QRS to maximum peak radial and circumferential strain (CS) in 6 segments on the left ventricular (LV) short-axis plane, and to the maximum peak of longitudinal strain in 18 segments on 3 apical LV planes was measured (Tmax). In segments with multiple peaks on the time-strain curves, time to the first peak (Tfirst) was also assessed. Difference in T between the earliest and latest segment and standard deviation (SD) of T in each strain component were assessed. CRT responders were defined as having LV end-systolic volume reduction >15% at 6 months after CRT. Clinical outcomes were assessed with a composite endpoint of death from cardiac causes or unplanned hospitalization for heart failure. Among 180 patients, 109 patients were identified as responders. Tfirst-SD of CS >116 ms was selected as the best independent predictor of CRT responders (P<0.001, hazard ratio=9.83, 95% confidence interval 3.78–25.6). In addition, Tfirst-SD of CS was associated with the clinical endpoints.Conclusions:This prospective multicenter study revealed the high feasibility of dyssynchrony assessment by STE, which may improve the ability to predict CRT responders. (Circ J 2015; 79: 613–622)

収録刊行物

  • Circulation Journal

    Circulation Journal 79 (3), 613-622, 2015

    一般社団法人 日本循環器学会

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