Relationship Between Left Ventricular Remodeling Assessed by Strain Echocardiography and Conventional Echocardiography Before and After Cardiac Resynchronization Therapy in Severe Heart Failure Patients

Background/Aims: To assess the relationship between left ventricular remodeling as evaluated by strain echocardiography and conventional echocardiography before and after cardiac resynchronization therapy (CRT) in patients with severe heart failure patients. Methods: A cross-sectional descriptive study with follow-up comparison before and after. The study was conducted on 33 heart failure patients indicated for CRT at the Vietnam National Heart Institute, Bach Mai Hospital from late 2015 to December 2021. Results: The study showed some correlations and changes in left ventricular remodeling assessed by strain echocardiography and conventional echocardiography before and after CRT. Left ventricular end-systolic volume and end-diastolic volume significantly decreased after 3 months of follow-up (p < 0.001) and had a strong inverse correlation with QRS recovery in study patients (r = 0.65). A positive correlation was observed between changes in left atrial volume index (LAVI) and 4B strain (r = 0.96, p < 0.05). After 3 months of CRT implantation, there was a positive correlation between the isovolumic relaxation time (IVRT) and left atrial volume (LAVI) (p < 0.05) and between the left atrial volume and E/e' obtained from tissue Doppler (r = 0.53, p < 0.05). However, there was no correlation observed between E/e' and total EF (r = -0.36, p > 0.05), between 2B strain and total EF (r = -0.36, p > 0.05) and between 2B strain and left atrial volume LAVI (r = 0.36, p > 0.05). Conclusion: Strain echocardiography is an important tool that cannot be overlooked in diagnosing, assessing risk factors, and monitoring heart failure. After 3 months of CRT implantation, there was significant improvement in left ventricular volume and ejection fraction (EF). This indicates better treatment effectiveness.