The speckle tracking imaging for the assessment of cardiac resynchronization therapy (START) study

Takeshi Maruo, Yoshihiro Seo, Satoshi Yamada, Takeshi Arita, Tomoko Ishizu, Tsuyoshi Shiga, Kaoru Doh, Hiroyuki Toide, Azusa Furugen, Katsuji Inoue, Masao Daimon, Hiroya Kawai, Hikaru Tsuruta, Kazuhiro Nishigami, Satoshi Yuda, Tomoya Ozawa, Chisato Izumi, Yuko Fumikura, Yasuaki Wada, Mariko DoiMasafumi Okada, Katsu Takenaka, Kazutaka Aonuma

    Research output: Contribution to journalArticlepeer-review

    26 Citations (Scopus)


    Background: We sought to identify the feasibility of speckle tracking echocardiography (STE) to predict cardiac resynchronization therapy (CRT) responders in a prospective multicenter study. Methods and Results: Patients who were newly implanted with a CRT device were enrolled. Time (T) from QRS to maximum peak radial and circumferential strain (CS) in 6 segments on the left ventricular (LV) short-axis plane, and to the maximum peak of longitudinal strain in 18 segments on 3 apical LV planes was measured (Tmax). In segments with multiple peaks on the time-strain curves, time to the first peak (Tfirst) was also assessed. Difference in T between the earliest and latest segment and standard deviation (SD) of T in each strain component were assessed. CRT responders were defined as having LV end-systolic volume reduction >15% at 6 months after CRT. Clinical outcomes were assessed with a composite endpoint of death from cardiac causes or unplanned hospitalization for heart failure. Among 180 patients, 109 patients were identified as responders. Tfirst-SD of CS >116 ms was selected as the best independent predictor of CRT responders (P<0.001, hazard ratio=9.83, 95% confidence interval 3.78–25.6). In addition, Tfirst-SD of CS was associated with the clinical endpoints. Conclusions: This prospective multicenter study revealed the high feasibility of dyssynchrony assessment by STE, which may improve the ability to predict CRT responders.

    Original languageEnglish
    Pages (from-to)613-622
    Number of pages10
    JournalCirculation Journal
    Issue number3
    Publication statusPublished - 2015

    All Science Journal Classification (ASJC) codes

    • Cardiology and Cardiovascular Medicine


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