P768Role of apical transverse motion to assess dysynchronous ventricles in patients with nonischemic cardiomyopathy


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Abstract

Purpose: Apical transverse motion (ATM) is a new parameter for assessing regional myocardial function abnormalities, as a promising predictor of response to cardiac resynchronization therapy (CRT). We investigated the role of ATM to assess dyssynchronous hearts in patients with nonischemic cardiomyopathies and its relationship with speckle tracking based deformation parameters.Methods: We examined 21 non-ischemic dilated cardiomyopathy (DCM) patients. Speckle-tracking analysis was performed to calculate global radial strain (GRS), global circumferential strain (GCS) and myocardial rotational parameters, from parasternal short-axis view; and global longitudinal strain (GLS) from apical views. Radial dysynchrony was defined as a time difference between the anteroseptal and posterior wall peak radial strain ≥ 130ms. ATM was calculated by motion traces of 2 opposite, apical regions.Results: ATM was positively correlated with QRS duration and radial dyssynchrony while negatively correlated with GCS, apical rotation (rot-A) and torsion. Discriminative power of ATM, to distinct patients with and without radial dyssynchrony, was high (AUC: 0,88 [CI 0,73-1,04, p<0,01]). An ATM cut-off value of >2,5mm predicted the presence of radial dyssynchrony (85% sensitivity and 86% specificity). Patients with higher ATM (>2,5) had a decreased GCS, Rot-A, torsion and increased radial dyssynchrony.Conclusions: Apical transverse motion has the ability to distinguish patients with and without dyssynchrony identified by speckle tracking radial strain. It is closely related to the myocardial rotational dynamics. Thus, we suggest to use quantitative measures of apical rocking for the selection of CRT candidates.

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