Vectorcardiography-derived index allows a robust quantification of ventricular electrical synchrony.
Vectorcardiography-derived index allows a robust quantification of ventricular electrical synchrony.
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DOI：
10.1038/s41598-022-14000-8
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发表时间：
2022-06-15
影响因子：
4.6
通讯作者：
Chara, Osvaldo
中科院分区：
文献类型：
--
作者：
Fernandez, Juan M. F.;Spagnuolo, Damian N.;Politi, Maria T.;Tello Santacruz, Ivan A.;Schiavone, Miguel;Caceres Monie, Cesar;Avaca, Horacio A.;Chara, Osvaldo
肌肉激活序列的改变是导致射血分数降低的心力衰竭的关键机制。成功的心脏再同步治疗(CRT)已经成为这些患者的标准治疗，但由于缺乏精确的不同步量化而受到限制。我们实施了一个计算流水线，允许通过从患者的心电图重建心电向量图来评估心室不同步。我们将心室不同步指数定义为个体观察的电压和速度时间积分与从健康人群中获得的这些变量的线性拟合之间的距离。该管道在1914名患者中进行了测试。不同步指数在健康对照组中最小，在左束支传导阻滞(LBBB)或起搏器(PM)患者中最大。我们建立了一个区分电不同步模式(LBBB和PM)和心室同步的临界不同步指标值。在10名使用PM或CRT装置的患者中，超过临界值的不同步指数与高应变峰值时间标准差相关，这是一种机械不同步的超声心动图测量指标。我们的指数被证明是一种很有前途的工具来评估心室激活不同步，潜在地增强了CRT候选者的选择，植入期间的设备配置，以及植入后的优化。
Alteration of muscle activation sequence is a key mechanism in heart failure with reduced ejection fraction. Successful cardiac resynchronization therapy (CRT), which has become standard therapy in these patients, is limited by the lack of precise dyssynchrony quantification. We implemented a computational pipeline that allows assessment of ventricular dyssynchrony by vectorcardiogram reconstruction from the patient’s electrocardiogram. We defined a ventricular dyssynchrony index as the distance between the voltage and speed time integrals of an individual observation and the linear fit of these variables obtained from a healthy population. The pipeline was tested in a 1914-patient population. The dyssynchrony index showed minimum values in heathy controls and maximum values in patients with left bundle branch block (LBBB) or with a pacemaker (PM). We established a critical dyssynchrony index value that discriminates electrical dyssynchronous patterns (LBBB and PM) from ventricular synchrony. In 10 patients with PM or CRT devices, dyssynchrony indexes above the critical value were associated with high time to peak strain standard deviation, an echocardiographic measure of mechanical dyssynchrony. Our index proves to be a promising tool to evaluate ventricular activation dyssynchrony, potentially enhancing the selection of candidates for CRT, device configuration during implantation, and post-implant optimization.
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DOI：
10.1016/j.amjcard.2016.05.017
发表时间：
2016-08-01
期刊：
The American journal of cardiology
影响因子：
--
作者：
Jacobsson J;Borgquist R;Reitan C;Ghafoori E;Chatterjee NA;Kabir M;Platonov PG;Carlson J;Singh JP;Tereshchenko LG
通讯作者：
Tereshchenko LG
影响因子：
5.5
作者：
Tereshchenko LG;Cheng A;Park J;Wold N;Meyer TE;Gold MR;Mittal S;Singh J;Stein KM;Ellenbogen KA;SMART-AV Trial Investigators
通讯作者：
SMART-AV Trial Investigators
心肌收缩效率的斑点追踪超声心动图分析可预测心脏再同步治疗的反应
影响因子：
1.9
作者：
Fulati Z;Liu Y;Sun N;Kang Y;Su Y;Chen H;Shu X
通讯作者：
Shu X
影响因子：
6.1
作者：
Pastore, Gianni;Morani, Giovanni;Barold, S. Serge
通讯作者：
Barold, S. Serge
影响因子：
24
作者：
Khan, Fakhar Z.;Virdee, Mumohan S.;Dutka, David P.
通讯作者：
Dutka, David P.