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The European Society of Cardiology

Strain rate imaging in CRT candidates

Ole A. Breithardta,*, Lieven Herbotsb, Jan D'Hoogeb, Piet Clausb, Bart Bijnensb, Christoph Stellbrinka, Andreas Frankea and George R. Sutherlandb

a Department of Cardiology, University Hospital Aachen, Aachen, Germany
b Department of Cardiology, University Hospital Gasthuisberg, Katholic University Leuven, Belgium

Received 3 May 2004; accepted 24 May 2004.

* Correspondence: Ole A. Breithardt, Department of Cardiology, University Hospital Aachen, D-52057 Aachen, Germany. Tel.: +49-241-808-9301; fax: +49-241-808-2303
obreithardt{at}ukaachen.de

Abstract

The recent introduction of cardiac resynchronization therapy (CRT) revived the interest how to evaluate asynchrony. Doppler myocardial imaging (DMI) allows quantification of both regional myocardial motion and deformation with adequate temporal resolution and has been suggested as a method of patient selection for CRT. Timing analysis of regional myocardial motion can identify heart failure patients with left ventricular asynchrony and has been shown to be of prognostic value in CRT patients. However, myocardial motion may be passive due to tethering effects. Strain rate imaging measures the timing and extent of myocardial deformation and provides more reliable information about the sequence of myocardial contraction in the presence of delayed electrical activation. The advantages and pitfalls of the different DMI techniques are discussed.

Key Words: Echocardiography • Pacing • Strain rate imaging • Heart failure • Cardiac resynchronization therapy


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