Strain imaging in CRT response (Version 1.1)
Research type
Research Study
Full title
The role of 2D strain imaging in assessing mechanical and functional response of the myocardium to cardiac resynchronisation therapy (CRT) in responders and non-responders.
IRAS ID
171137
Contact name
Jonathan Sibley
Contact email
Sponsor organisation
Basildon and Thurrock University Hospital
Duration of Study in the UK
1 years, months, days
Research summary
The need for the project is to validate a current local pathway for Cardiac Resynchronisation Therapy (CRT). CRT is devise implanted for patients with heart failure to reduce symptoms and resynchronise the heart. Currently, 30% of patients do not respond to CRT devise and therefore there are no improvements in the patients heart failure symptoms. Most trusts measure response to a CRT by asking a patient “do you feel better since your devise implant”. This is a subjective way of measuring response. Increasing suggests mechanical response of the heart the best measure of response. There are various methods of detecting mechanical response but there is contradicting research as to which is the best method. One method which is gaining more evidence and is currently being used in our trust is strain imaging (Gorscan et al, 2008; Lim et al, 2008; Yu et al, 2007; Becker et al, 2007). Its use is predominately research based but rarely applied in a clinical setting. The variables measured in strain imaging will be circumferencial and radial strain which are a measure of mechanical dyssynchrony and global longitudinal strain (GLS) which will be a measurement for left ventricular dysfunction. Thus, this study will aim to provide quantitative data regarding the overall mechanical activity of the heart in response to CRT. The MLHFQ will be used as research tool to identify if a patient is a responder or non-responder to CRT (Molhoek et al, 2004). Therefore, we will able to identify whether responders do respond mechanically (using strain imaging) and thus discarding a placebo effect. Also, it will identify whether non-responders maintain mechanical dyssynchrony and dysfunction (therefore they are true non-responders) or whether they are symptomatic due to other causes.
Therefore, this study will show the importance of using the MLHFQ to identify responders and non-responders and gain potential insight into why non-responders do not respond. It will also show the importance of strain imaging in measuring response.REC name
London - South East Research Ethics Committee
REC reference
15/LO/0397
Date of REC Opinion
24 Mar 2015
REC opinion
Further Information Favourable Opinion