CORELATION OF STRAIN ECHO IN PATIENTS WITH DILATED CARDIOMYOPATHY PRE AND POST CARDIAC RESYNCHRONISATION THERAPY IMPLANTATION

Background:* Echocardiographic strain (strain echo) is a novel, non-invasive method for assessing myocardial damage in cardiomyopathy. It differentiates between active and passive myocardial segment movements, evaluates myocardial functions, detects early myocardial damage, and is useful for follow-up evaluations post-cardiac surgery. Strain rate and strain echo can predict reverse remodeling after cardiac resynchronization therapy (CRT) and outcomes with or without ventricular assist device (VAD) implantation. *Objective:* This study assesses strain echocardiography changes and desynchrony in patients with dilated cardiomyopathy (DCM) before and after CRT-D implantation. *Methods:* A cross-sectional observational study was conducted over 18 months at the Department of Cardiology, involving patients with DCM undergoing CRT-D implantation. Inclusion criteria were patients over 18 with diagnosed DCM and candidates for CRT-D implantation. Exclusion criteria included non-candidates for CRT-D, those unwilling to consent, and pregnant women. Various diagnostic tools were used, including 12-lead ECG, 2D echocardiography, M-mode, Doppler, strain echo, Holter monitoring, and coronary angiography. Statistical analysis was performed using Epi Info 7.2.2.2. *Results:* Signicant improvements were observed in strain parameters post-CRTD implantation: GLS improved from -5.25±1.03 to -9.72±2.49 (p<0.0001), GCS from -5.36±1.02 to -9.64±2.18 (p<0.0001), and GRS from 9.92±2.04 to 13.93±2.93 (p<0.0001). This indicates early detection and intervention in DCM patients can signicantly reduce disease progression. *Conclusion:* Strain echocardiography, combined with conventional 2D echocardiography, should be performed early in the disease course to improve patient management, quality of life, and healthcare costs. CRT-D implantation signicantly improves both clinical and echocardiographic outcomes. Despite potential observer bias and technical limitations, including the need for high-quality images and software differences, strain echocardiography remains a critical tool in managing DCM.