Assessment of left ventricular asynchrony using volume-time curves of 16 segments by real-time 3 dimensional echocardiography: comparison with tissue Doppler imaging

BACKGROUND: Recent technical developments with high-resolution real-time 3 dimensional echocardiography (RT3DE) facilitate the acquisition of high quality images and the analysis of segmental volume-time curves (VTCs). AIMS: To assess left ventricular (LV) asynchrony using the VTCs of 16 segments by RT3DE, and to evaluate accuracy compared to tissue Doppler imaging (TDI). METHODS: Twenty-three heart failure (HF) patients (LVEF: 25+/-6%, age: 60+/-13 years) and 16 normal controls underwent TDI and RT3DE. The standard deviation (SD3) of the end systolic time reaching minimal systolic volume for the 16 segments on VTCs was obtained by RT3DE. The standard deviation (SD2) of the electromechanical coupling time for the 8 segments was measured using TDI. RESULTS: SD3 was markedly higher in HF patients than in controls (7.7+/-2.5 vs 1.5+/-1.0%, P<0.01) and increased as LVEF decreased (r=-0.85, P<0.01). SD2 was also significantly higher in HF patients (27.0+/-8.6 vs 12.6+/-5.0 ms, P<0.01) and had a good negative correlation with LVEF (r=-0.72, P<0.01). SD3 was well correlated to SD2 (r=0.66, P<0.01). CONCLUSIONS: We suggest that analysis of VTCs in 16 segments using RT3DE may be a useful alternative to TDI for the evaluation of LV asynchrony.