Echocardiography in the Identification of Responders:The Novel Role of Tissue Doppler Imaging and Strain Imaging

  • S. Carerj
  • C. Zito
Conference paper


Biventricular pacing (BivP) has been proposed as an adjunctive nonpharmacological therapy for patients with chronic heart failure (HF) who have electromechanical delay. It is already known that BivP improves symptoms, exercise capacity, quality of life and systolic function in these patients. The French pilot study, the Insync PATH-CHF I study, and the recent MUSTIC and MIRACLE trials have shown the improvement of outcome in HF patients calculated in different ways: myocardial oxygen consumption, distance covered during a 6-min walking test, estimation of NYHA functional class, and assessment of quality of life [1]. Recently, it has been demonstrated that BivP is effective in regressing left ventricular (LV) remodeling.


Right Ventricular Cardiac Resynchronization Therapy Tissue Doppler Imaging Left Bundle Branch Block Biventricular Pace 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gras D, Leclercq C, Tang AS et al (2002) Cardiac resynchronization therapy in advanced heart failure: the multicenter InSync clinical study. Eur J Heart Fail 4:311–320PubMedCrossRefGoogle Scholar
  2. 2.
    Abraham WT (2000) Rationale and design of a randomized clinical trial to assess the safety and efficacy of cardiac resynchronization therapy in patients with advanced heart failure: the Multicenter InSync Randomized Clinical Evaluation (MIRACLE). J Card Fail 6:369–380PubMedCrossRefGoogle Scholar
  3. 3.
    Porciani MC, Puglisi A, Colella A et al, on behalf of the InSync Italian Registry Investigators (2000) Echocardiographic evaluation of the effect of biventricular pacing: the InSync Italian Registry. Eur Heart J [Suppl J]:J23–J30Google Scholar
  4. 4.
    Brecker SJ, Gibson DG (1996) What is the role of pacing in dilated cardiomyopathy? Eur Heart 1 17:819–824CrossRefGoogle Scholar
  5. 5.
    Siagaard P, Egeblad H, Yong Kim W et al (2002) Tissue doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during longterm cardiac resynchronization therapy. J Am Coll Cardiol 40:723–730CrossRefGoogle Scholar
  6. 6.
    Yu CM, Chau E, Sanderson JE et al (2002) Tissue Doppler echocardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure. Circulation 105:438–445PubMedCrossRefGoogle Scholar
  7. 7.
    Ansalone G, Giannantoni P, Ricci R et al (2002) Doppler myocardial imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing. J Am Coll Cardiol 39:489–499PubMedCrossRefGoogle Scholar
  8. 8.
    Mele D, Aggio S, Pasanisi G et al (2002) Quantitative tissue doppler can measure and localize improvement of ventricular dyssynchrony in dilated cardiomyopathy after biventricular pacing. Eur Heart J 4[Abstr. Suppl1:651Google Scholar
  9. 9.
    D’Hooge J, Heimdal A, Jamal F et al (2000) Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr 1:154–170PubMedCrossRefGoogle Scholar
  10. 10.
    Breithardt OA, Stelbrinck C, Herbots L et al (2002) Effects of cardiac resynchronization therapy on regional myocardial deformation as measured by echocardiographic strain rate imaging. Eur Heart J 4[Abstr. Supp1]:3Google Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • S. Carerj
    • 1
  • C. Zito
    • 1
  1. 1.Dipartimento Clinico-Sperimentale di Medicina e FarmacologiaPoliclinico G. MartinoItaly

Personalised recommendations