Mechanical left ventricular dyssynchrony detection by endocardium displacement analysis with 3D speckle tracking technology
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Myocardium deformation and displacement analysis by echocardiography has proven useful to evaluate the synchrony of myocardial mechanics. The aim of our study was to evaluate the mean standard deviation of time to longitudinal peak displacement in 16 cardiac segments by 3D echo wall motion Speckle Tracking analysis. We studied 15 patients with ventricular dyssynchrony—defined by a QRS > 120 ms in the ECG. We obtained the differences between time peaks of endocardial longitudinal displacement for 16 segments of the heart by 3D echo Speckle Tracking. We compared the temporal dispersion of these peaks with results obtained in a control group of 13 healthy individuals without dyssynchrony. The results showed a significant difference (p < 0,001) between the dispersion of standard deviation in the 13 patients in the control group (34 ms ± 19) and the 15 patients in the dyssynchrony group (117 ms ± 57). We describe a new parameter obtained by 3D echo wall motion Speckle Tracking analysis for the detection of dyssynchrony. It can be useful to identify dyssynchrony of left ventricular myocardial mechanics, to indicate the resynchronization therapy, to optimize the parameters of the device and to achieve a less operator-dependent evaluation.
KeywordsDyssynchrony Heart failure Echocardiography Electrophysiology Cardiomyopathy Pacemaker
We thank Toshiba Medical Systems for the loan of a 3D Artida® echocardiograph to complete the study, and Dr. Ignasi Gich for help with statistical analysis.
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