A modified echocardiographic protocol with intrinsic plausibility control to determine intraventricular asynchrony based on TDI and TSIReportar como inadecuado

A modified echocardiographic protocol with intrinsic plausibility control to determine intraventricular asynchrony based on TDI and TSI - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Cardiovascular Ultrasound

, 7:46

First Online: 25 September 2009Received: 12 August 2009Accepted: 25 September 2009


BackgroundEstablished methods to determine asynchrony suffer from high intra- and interobserver variability and failed to improve patient selection for cardiac resynchronization therapy CRT. Thus, there is a need for easy and robust approaches to reliably assess cardiac asynchrony.

Methods and ResultsWe performed echocardiography in 100 healthy subjects and 33 patients with left bundle branch block LBBB. To detect intraventricular asynchrony, we combined two established methods, i.e., tissue synchronization imaging TSI and tissue Doppler imaging TDI. The time intervals from the onset of aortic valve opening AVO to the peak systolic velocity S- were measured separately in six basal segments in the apical four-, two-, and three-chamber view. Color-coded TSI served as an intrinsic plausibility control and helped to identify the correct S- measuring point in the TDI curves. Next, we identified the segment with the shortest AVO-S- interval. Since this segment most likely represents vital and intact myocardium it served as a reference for other segments. Segments were considered asynchronous when the delay between the segment in question and the reference segment was above the upper limit of normal delays derived from the control population. Intra- and interobserver variability were 7.0% and 7.7%, respectively.

ConclusionOur results suggest that combination of TDI and TSI with intrinsic plausibility control improves intra- and interobserver variability and allows easy and reliable assessment of cardiac asynchrony.

List of abbreviationsAVOaortic valve opening

CHFchronic heart failure

CRTcardiac synchronization therapy

CVcoefficient of variation

LBBBleft bundle branch block

LVleft ventricle

LVEFleft ventricular ejection fraction

ROCreceiver operating characteristic

S-peak systolic velocity

SDstandard deviation

TDItissue Doppler imaging

TSItissue synchronization imaging.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-7120-7-46 contains supplementary material, which is available to authorized users.

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Autor: Henryk Dreger - Adrian C Borges - Bruno Ismer - Sebastian Schattke - Berthold Stegemann - Gert Baumann - Christoph Melzer

Fuente: https://link.springer.com/

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