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A Novel Index Combining Diastolic and Systolic Tissue Doppler Parameters for Predicting Cardiac Resynchronization Therapy Response
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  • Selma Arı,
  • Hasan ARI,
  • Ahmet Tütüncü,
  • Sencer Çamcı,
  • Fahriye Vatansever,
  • Mehmet Melek
Selma Arı
Bursa Postgraduate Hospital
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Hasan ARI
Bursa Postgraduate Hospital
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Ahmet Tütüncü
Bursa Postgraduate Hospital
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Sencer Çamcı
Bursa Postgraduate Hospital
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Fahriye Vatansever
Bursa Postgraduate Hospital
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Mehmet Melek
Bursa Postgraduate Hospital
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Abstract

Objective:Identification of patients who are nonresponders to cardiac resynchronization therapy (CRT) with the use of simple and objective parameters may be helpful in tailoring treatment. The aim of this study is to investigate whether E/(Ea×Sa) could be a predictor of CRT nonresponders (E=early diastolic transmitral velocity, Ea=early diastolic mitral annular velocity, Sa=systolic mitral annular velocity). Methods:In total, 53 heart failure patients were evaluated for this study, and 33 patients were included according to the study criteria. Before and six months after CRT-D(CRT with a defibrillator) implantation, E, Ea, and Sa were determined at the medial and lateral mitral annular sites, and the average values were obtained. E/(Ea×Sa) was calculated (medial, lateral, average). The patients were followed for six months to monitor their CRT response. A responder was defined as a patient with a reduction in end-systolic volume of <15% and an increase in six-minute walking distance of 50 meters. Results:At a six-month follow-up, 24(72.7%) of the 33 patients responded to CRT. At the six-month follow-up, in the responder group, the E/Ea ratio, lateral mitral, and average E/(Ea×Sa) indices were significantly reduced (p<0.01 for all). The baseline lateral mitral, medial mitral, and average E/(Ea×Sa) indices were significantly lower in the responder group than in the nonresponder group (p≤0.01 for all). The ROC analysis showed that all the E/(Ea×Sa) indices predict the CRT nonresponder patients. The AUC values were 0.89(lateral E/(Ea×Sa)), 0.85(average E/(Ea×Sa)), and 0.77(medial E/(Ea×Sa))(p≤0.01 for all). Conclusion:We found that the E/(Ea×Sa) index is a novel predictor of CRT nonresponder patients.

Peer review status:Published

22 May 2020Submitted to Echocardiography
23 May 2020Submission Checks Completed
23 May 2020Assigned to Editor
23 May 2020Reviewer(s) Assigned
13 Jun 2020Review(s) Completed, Editorial Evaluation Pending
13 Jun 2020Editorial Decision: Revise Major
24 Jun 20201st Revision Received
25 Jun 2020Assigned to Editor
25 Jun 2020Submission Checks Completed
25 Jun 2020Reviewer(s) Assigned
01 Jul 2020Review(s) Completed, Editorial Evaluation Pending
02 Jul 2020Editorial Decision: Revise Minor
02 Jul 20202nd Revision Received
03 Jul 2020Assigned to Editor
03 Jul 2020Submission Checks Completed
03 Jul 2020Review(s) Completed, Editorial Evaluation Pending
05 Jul 2020Editorial Decision: Accept
26 Jul 2020Published in Echocardiography. 10.1111/echo.14797