Left ventricular 12 segmental strain imaging predicts response to cardiac resynchronization therapy.

The number of non-responders to cardiac resynchronization therapy (CRT) exposes the need for better patient selection criteria for CRT. This study aimed to identify echocardiographic parameters that would predict the response to CRT.Forty-five consecutive patients receiving CRT-D implantation for heart failure (HF) were included in this prospective study. New York Heart Association (NYHA) class, 6-minute walk distance, electrograph character, and multi echocardiographic parameters, especially in strain patterns, were measured and compared before and six months after CRT in the responder and non-responder groups. Response to CRT was defined as a decrease in left ventricular endsystolic volume (LVESV) of 15% or more at 6-month follow up.Twenty-two (48.9%) patients demonstrated a response to CRT at 6-month follow-up. Significant improvement in NYHA class (P < 0.01), left ventricular end-diastolic volume (LVEDV) (P < 0.01), and 6-minute walk distance (P < 0.01) was shown in this group. Although there was an interventricular mechanical delay determined by the difference between left and right ventricular pre-ejection intervals ((42.87 ± 19.64) ms vs. (29.43 ± 18.19) ms, P = 0.02), the standard deviation of time to peak myocardial strain among 12 basal, mid and apical segments (Tε-SD) ((119.97 ± 43.32) ms vs. (86.62 ± 36.86) ms, P = 0.01) and the non-ischemic etiology (P = 0.03) were significantly higher in responders than non-responders, only the Tε-SD (OR = 1.02, 95% CI = 1.01 - 1.04, P = 0.02) proved to be a favorable predictor of CRT response after multivariate Logistic regression analysis.The left ventricular 12 segmental strain imaging is a promising echocardiographic parameter for predicting CRT response.