الفهرس 
Heart failure andOnly 14 pages are availabe for public view
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Abstract
Cardiac resynchronization therapy has been found to result in significant clinical improvement in patients who have moderate to severe heart failure and a wide QRS complex on ECG. It has become a viable treatment option for eligible patients according to the guidelines of both the ACC/AHA and the European Society of Cardiology.
Echocardiography plays an important role in the care of patients with heart failure as well as in the assessment and follow up of those HF patients treated with cardiac resynchronization therapy.
Real-time three-dimensional echocardiography has emerged as a novel technique to quantify global left ventricular mechanical dyssynchrony in patients with chronic heart failure being considered for cardiac resynchronization therapy.
The current study was done in order to examine the use of RT3DE in the assessment of LVMD in comparison to DTI.
It included 60 patients who were considered candidates for CRT according to the current guidelines. Each patient was subjected to proper history taking, thorough clinical examination, full echocardiographic examination, DTI to estimate the different DTI-derived dyssynchrony indices and RT3DE “full volume” acquisition to assess LV volumes, EF and to estimate SDI-16.
No significant statistical differences existed among the study population’s baseline patient characteristics, etiology of HF and QRS duration.
RT3DE was able to measure all 16 segments of the myocardium simultaneously from a single acoustic window including the apical segments.
Having ischemic origin of cardiomyopathy seemed to affect dyssynchrony indices assessment.
LV volumes and ejection fraction measurement by RT3DE was highly accurate with near perfect correlation to standard 2-D echocardiography measurements.
A high concordance rate was present between SDI-16 and Ts-SD for assessing the presence of LVMD.
SDI-16 was found to increase with worsening of the LV systolic functions and widening of the QRS complex.
It was concluded that the different echocardiographic dyssynchrony indices seemed to provide complementary rather than contradicting information to each other regarding the presence of LVMD.