Optimization of Pulsed Wave Tissue Doppler to Predict Left Ventricular Reverse Remodeling After Cardiac Resynchronization Therapy Annemieke H.M. Jansen,

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Optimization of Pulsed Wave Tissue Doppler to Predict Left Ventricular Reverse Remodeling After Cardiac Resynchronization Therapy Annemieke H.M. Jansen, MD, Frank Bracke, MD, PhD, Jan M. van Dantzig, MD, PhD, Albert Meijer, MD, PhD, Erik H.M. Korsten, MD, PhD, Kathinka H. Peels, MD, Norbert M. van Hemel, MD, PhD Journal of the American Society of Echocardiography Volume 19, Issue 2, Pages 185-191 (February 2006) DOI: 10.1016/j.echo.2005.08.021 Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 1 Pulsed wave tissue Doppler tracings of the inferoseptal wall. (A) TsO; (B) TsP. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 2 Pulsed wave tissue Doppler tracing without a clearly defined peak systolic velocity: systolic velocity plateau pattern. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 3 TsO of the 6 basal LV segments of the responders before and 3 months after biventricular pacing. IS, inferoseptal; LAT, lateral; ANT, anterior; INF, inferior; Post, posterior; AS, anteroseptal. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 4 TsO of the 6 basal LV segments of the nonresponders before and 3 months after biventricular pacing. IS, inferoseptal; LAT, lateral; ANT, anterior; INF, inferior; Post, posterior; AS, anteroseptal. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 5 Column bar of the latest activated LV segments using TsO. The white columns represent the number of last activated segments in only 1 wall; the black columns represent all latest activated segments, including multiple sites. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 6 ROC curves of the different pulsed wave tissue Doppler methods in predicting LV reverse remodeling to CRT. TsO SD-6, standard deviation of 6 LV segments using TsO; AUC, area under the curve; TsP SD-6, standard deviation of 6 LV segments using TsP; TsO longest delay, the longest difference between any 2 LV segments using TsO; TsO AS-Post, absolute difference between the anteroseptal and posterior wall using TsO. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 7 Scatter diagram of the standard deviation (SD) of 6 LV segments using TsO versus LVESV change. The cutoff value for the TsO SD-6 was ≥ 20.4 ms. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions

Figure 8 Scatter diagram of the standard deviation (SD) of 6 LV segments using TsP versus LVESV change. The cutoff value for the TsP SD-6 was ≥ 31.3 ms. Journal of the American Society of Echocardiography 2006 19, 185-191DOI: (10.1016/j.echo.2005.08.021) Copyright © 2005 American Society of Echocardiography Terms and Conditions