Usefulness of myocardial tissue Doppler echocardiography to evaluate left ventricular dyssynchrony before and after biventricular pacing in patients with idiopathic dilated cardiomyopathy

• Published in: The American journal of cardiology Vol. 91; no. 1; pp. 94 - 97
• Main Authors: Bax, Jeroen J., Molhoek, Sander G., van Erven, Lieselot, Voogd, Paul J., Somer, Soeresh, Boersma, Eric, Steendijk, Paul, Schalij, Martin J., Van der Wall, Ernst E.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2003; Elsevier; Elsevier Limited
• Subjects: Biological and medical sciences; Cardiac arrhythmia; Cardiac Pacing, Artificial - methods; Cardiomyopathy, Dilated - diagnostic imaging; Cardiomyopathy, Dilated - therapy; Chi-Square Distribution; Diseases of the cardiovascular system; Echocardiography, Doppler; Electrocardiography; Female; Heart failure; Humans; Male; Medical sciences; Middle Aged; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Transplants & implants; Ventricular Function, Left; Sonography; Doppler ultrasound study; Human; Heart failure; Echocardiography; Treatment efficiency; Idiopathic; Instrumentation therapy; Cardiovascular disease; Bilateral; Exploration; Heart ventricle; Synchronization; Myocardial disease; Left ventricle; Instrumental stimulation; Treatment; Congestive hypertrophic cardiomyopathy; Pacemaker; Heart disease; Myocardium
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(02)03009-6

Recently, simultaneous biventricular pacing has been proposed as an alternative treatment in patients with drug refractory heart failure. The clinical benefit of biventricular pacing has been demonstrated in various studies; improvement in heart failure symptoms, quality-of-life, exercise capacity, and left ventricular (LV) systolic performance have been shown. It has been suggested that the success of biventricular pacing is mainly related to resynchronization of the ventricular septum to the LV lateral free wall. Myocardial tissue Doppler imaging (TDI) is an echocardiographic technique that allows noninvasive quantification of the peak systolic myocardial velocity and the timing of this peak velocity in relation to electrical activity (QRS on electrocardiogram). Theoretically, this technique could be very useful in evaluating the dyssynchrony in patients with dilated cardiomyopathy and the resynchronization after biventricular pacing; initial data are promising. Accordingly, consecutive patients with drug refractory heart failure who underwent implantation of a biventricular pacemaker were evaluated with TDI before and after implantation.