Evaluation Of Left Ventricular Systolic And Diastolic Synchronicity Before And After Optimal Biventricular Pacing By Three-dimensional Speckle Tracking

ObjectiveTo evaluate left ventricular systolic and diastolic synchronicity before and after optimal biventricular pacing by three-dimensional speckle tracking.Methods21chronic heart failure (CHF) patients with cardiac resynchronization therapy (CRT) were enrolled. Toshiba Artida4D system with PST-25SX probe were used to perform3D-STI in heart failure patients three days before CRT and one week after CRT and immediately after optimal biventricular pacing. The left ventricular end systolic volume(LVESV), left ventricular end diastolic volume(LVEDV) and left ventricular ejection fraction(LVEF) were obtained. The left ventricular dyssynchrony datasets which include the standard deviation of time to peak area tracking in the16left ventricular segments (AT-SD) and the maximum difference of time to peak area tracking in the16left ventricular segments (AT-Dif) were also investigated. And N-terminal pro-B-type natriuretic peptide (NT-proBNP) were obtained in three days before CRT and one week after CRT.Analyze the changes of left ventricular systolic and diastolic synchronicity between three days before CRT and one week after CRT and immediately after optimal biventricular pacing.Results(1) There was significant difference of NT-proBNP in three days before CRT and after it (P＜O.001).(2) Compared with three days before CRT, the LVEDV and LVESV and AT-SD and AT-Dif were decreased significantly in one week after CRT(P<0.001),and the LVEF was increased significantly(P<0.001).(3) Immediately after optimal biventricular pacing, the LVESV and AT-SD and AT-Dif were decreased further (P<0.05), and the LVEF was increased further (P＜O.05), while there was no significant change of LVEDV (P>0.05).ConclusionThe function of left ventricular and the systolic and diastolic synchronicity improved greatly after CRT, and the function of left ventricular and the systolic and diastolic synchronicity further improved after optimal biventricular pacing.Optimized VV interval of the pacemaker parameters enhanced the efficacy of CRT.