1/19/2024 0 Comments Philips qlab options![]() The Markers and Response to CRT (MARC) study was designed to investigate predictors for response on CRT, including several echocardiographic parameters. The hypothesis of this study is that vendors may have good agreement on global parameters and timing indices in patients eligible for CRT, while agreement on more detailed parameters and dyssynchrony parameters may be poor. GE EchoPac and Philips QLAB (Philips Medical Systems, Best, The Netherlands)), and the vendor-independent system of TomTec 2DCPA (TomTec Imaging Systems GmbH, Unterschleissheim, Germany). ![]() STE software of two commonly used vendors was used (i.e. It was the aim of this study to compare strain parameters and more specifically dyssynchrony parameters derived from longitudinal strain analysis of different vendors of STE software, implemented specifically in CRT patients, as well as the association of derived dyssynchrony parameters with volumetric response to CRT. However, inter vendor comparability of results obtained in patients with LV dyssynchrony is unknown. A taskforce of the European Association of Cardiovascular Imaging and American Society of Echocardiography (EACVI/ASE) was appointed to standardize longitudinal strain results and specifically global values. Between these platforms, differences in derived results are known, complicating the interpretation of specific study results and restricting their use in clinical practice. However, several other commercially available vendor dependent and independent software platforms have been developed for STE. Publications on these parameters mainly use STE software of General Electric EchoPac (Chicago, Illinois, United States). Prediction of volumetric response and outcome to CRT has been approached using several STE derived parameters for mechanical dyssynchrony. Response prediction is an important aspect of clinical decision making, since 20–50% of patients are still non-responders to CRT despite meeting internationally acknowledged selection criteria. The use of STE in cardiac resynchronization therapy (CRT) has received increasing interest the past years, with respect to multiple aspects: optimization of left ventricular (LV) lead positioning, myocardial viability, optimization of CRT device configuration, determining mechanical dyssynchrony, and predicting volumetric response and outcome. Speckle tracking echocardiography (STE) is used to assess myocardial deformation and strain in research setting as well as in clinical practice. While the standardization taskforce took an important step for global peak strain, further standardization of STE is still warranted. ConclusionsĪlthough global longitudinal strain analysis showed fair comparability, assessment of dyssynchrony parameters was vendor specific and not applicable outside the context of the implemented platform. SRSsept and SSI had relative varying C-statistic values (range: 0.530–0.705) and different cut-off values between vendors. Septal strain patterns, SRSsept and SSI were associated with changes in LV end-systolic volume for all vendors. Comparability of septal strain patterns was low (Cohen’s kappa, GE vs. ICC’s of SRSsept and SSI were higher but only weak (GE vs. Two-hundred eleven patients were analysed. Dyssynchrony parameters were associated with CRT response using univariate regression analysis and C-statistics. The coefficient of variation and intra-class correlation coefficient (ICC) were analysed. Septal strain patterns were categorized in three types. Basic longitudinal strain and mechanical dyssynchrony parameters (septal to lateral wall delay (SL-delay), septal systolic rebound stretch (SRSsept), and systolic stretch index (SSI)) were obtained from either separate septal and lateral walls, or total LV apical four chamber. Response was defined as change in left ventricular (LV) end-systolic volume between examination before and six-months after CRT implantation. In the MARC study, echocardiographic images of heart failure patients obtained before CRT implantation were prospectively analysed with vendor specific STE software (GE EchoPac and Philips QLAB) and vendor-independent software (TomTec 2DCPA). Although mechanical dyssynchrony parameters derived by speckle tracking echocardiography (STE) may predict response to cardiac resynchronization therapy (CRT), comparability of parameters derived with different STE vendors is unknown.
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