ABSTRACT
Objective To assess the efficacy of cardiac resynchronization therapy (CRT) using real-time three-dimen?sional echocardiography (RT-3DE) and speckle tracking imaging (STI) in patients with heart failure. Methods Thirty-one patients with chronic heart failure were examined by RT-3DE and STI before CRT and 3, 6 months after CRT. The values of left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured. RT-3DE was used to evaluate the minimum regional volume for 16 segments (Tmsv-16SD) and the ratio of Tmsv16SD to R-R interval, and the maximum time difference (Tmsv-16Dif). STl was used to evaluate the ratios of standard deviation of the time to peak longitudinal radial and circumferential strain to R-R interval (Tls-16SD%, Trs-16SD%,Tcs-16SD%) from the beginning of Q wave of electrocardiography to the point minimal systolic volume of all 16 segments and the maximum time difference. Results The values of LVEDV and LVESV were smaller 3 and 6 months after CRT than those before CRT. The value of LVEF was significantly improved after CRT (P < 0.05). The values of Tmsv-16SD%, Tmsv-16Dif%, Tls-16SD%, Trs-16SD%, Tcs-16SD%and T-Dif%were gradually decreased after CRT (P<0.05). The values of Tmsv-16SD%, Tmsv-16Dif%,Trs-16SD%and Tcs-16SD%were negatively related with LVEF (r=-0.79,-0.82,-0.69 and-0.74(P<0.05). The better consistency was found between RT-3DE and STI methods(Kappa=0.77). Conclusion Re?al-time three-dimensional echocardiography and speckle tracking imaging can provide more accurate quantitative informa?tion of cardiac resynchronization therapy for assessment of treatment and prognosis in patients with heart failure.