Statistical ranking of electromechanical dyssynchrony parameters for CRT
Objective Mechanical evaluation of dyssynchrony by echocardiography has not replaced ECG in routine cardiac resynchronisation therapy (CRT) evaluation because of its complexity and lack of reproducibility. The objective of this study was to evaluate the potential correlations between electromechanic...
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BMJ Publishing Group
2019-05-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/6/1/e000933.full |
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| author | Serge Cazeau Matthieu Toulemont Philippe Ritter Julien Reygner |
| author_facet | Serge Cazeau Matthieu Toulemont Philippe Ritter Julien Reygner |
| author_sort | Serge Cazeau |
| collection | DOAJ |
| description | Objective Mechanical evaluation of dyssynchrony by echocardiography has not replaced ECG in routine cardiac resynchronisation therapy (CRT) evaluation because of its complexity and lack of reproducibility. The objective of this study was to evaluate the potential correlations between electromechanical parameters (atrioventricular, interventricular and intraventricular from the dyssynchrony model presented in 2000), their ability to describe dyssynchrony and their potential use in resynchrony.Methods 455 sets of the 18 parameters of the model obtained in 91 patients submitted to various pacing configurations were evaluated two by two using a Pearson correlation test and then by groups according to their ability to describe dyssynchrony, using the Column selection method of machine learning.Results The best parameter is duration of septal contraction, which alone describes 25% of dyssynchrony. The best groups of 3, 4 and ≥8 variables describe 59%, 73% and almost 100% of dyssynchrony, respectively. Left pre-ejection interval is highly and significantly correlated to a maximum of other variables, and its decrease is associated with the favourable evolution of all other correlated parameters. Increase in filling duration and decrease in duration of septum to lateral wall contraction difference are not associated with the favourable evolution of other parameters.Conclusions No single electromechanical parameter alone can fully describe dyssynchrony. The 18-parameter model can be simplified, but still requires at least 4–8 parameters. Decrease in left pre-ejection interval favourably drives resynchrony in a maximum of other parameters. Increase in filling duration and decrease in septum–lateral wall difference do not appear to be good CRT targets. |
| format | Article |
| id | doaj-art-43144f7c342649ae907c29bba811e53f |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | BMJ Publishing Group |
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| series | Open Heart |
| spelling | doaj-art-43144f7c342649ae907c29bba811e53f2024-11-12T07:15:08ZengBMJ Publishing GroupOpen Heart2053-36242019-05-016110.1136/openhrt-2018-000933Statistical ranking of electromechanical dyssynchrony parameters for CRTSerge Cazeau0Matthieu Toulemont1Philippe Ritter2Julien Reygner31 Service de Cardiologie, Hôpital Saint-Joseph, Paris, France3 Ecole des Ponts Paristech, Marne-la-Vallée, France4 Cardiology Department, University Hospital of Bordeaux, Pessac, France5 Center for Training and Research in MathematIcs and Scientific Computing (CERMICS), Université Paris-Est, ENPC, Marne-la-Vallée, FranceObjective Mechanical evaluation of dyssynchrony by echocardiography has not replaced ECG in routine cardiac resynchronisation therapy (CRT) evaluation because of its complexity and lack of reproducibility. The objective of this study was to evaluate the potential correlations between electromechanical parameters (atrioventricular, interventricular and intraventricular from the dyssynchrony model presented in 2000), their ability to describe dyssynchrony and their potential use in resynchrony.Methods 455 sets of the 18 parameters of the model obtained in 91 patients submitted to various pacing configurations were evaluated two by two using a Pearson correlation test and then by groups according to their ability to describe dyssynchrony, using the Column selection method of machine learning.Results The best parameter is duration of septal contraction, which alone describes 25% of dyssynchrony. The best groups of 3, 4 and ≥8 variables describe 59%, 73% and almost 100% of dyssynchrony, respectively. Left pre-ejection interval is highly and significantly correlated to a maximum of other variables, and its decrease is associated with the favourable evolution of all other correlated parameters. Increase in filling duration and decrease in duration of septum to lateral wall contraction difference are not associated with the favourable evolution of other parameters.Conclusions No single electromechanical parameter alone can fully describe dyssynchrony. The 18-parameter model can be simplified, but still requires at least 4–8 parameters. Decrease in left pre-ejection interval favourably drives resynchrony in a maximum of other parameters. Increase in filling duration and decrease in septum–lateral wall difference do not appear to be good CRT targets.https://openheart.bmj.com/content/6/1/e000933.full |
| spellingShingle | Serge Cazeau Matthieu Toulemont Philippe Ritter Julien Reygner Statistical ranking of electromechanical dyssynchrony parameters for CRT Open Heart |
| title | Statistical ranking of electromechanical dyssynchrony parameters for CRT |
| title_full | Statistical ranking of electromechanical dyssynchrony parameters for CRT |
| title_fullStr | Statistical ranking of electromechanical dyssynchrony parameters for CRT |
| title_full_unstemmed | Statistical ranking of electromechanical dyssynchrony parameters for CRT |
| title_short | Statistical ranking of electromechanical dyssynchrony parameters for CRT |
| title_sort | statistical ranking of electromechanical dyssynchrony parameters for crt |
| url | https://openheart.bmj.com/content/6/1/e000933.full |
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