TY - JOUR
T1 - Impact of Left Ventricular Size on Tissue Doppler and Longitudinal Strain by Speckle Tracking for Assessing Wall Motion and Mechanical Dyssynchrony in Candidates for Cardiac Resynchronization Therapy
AU - Lim, Pascal
AU - Mitchell-Heggs, Laurens
AU - Buakhamsri, Adisai
AU - Thomas, James D.
AU - Grimm, Richard A.
N1 - Funding Information:
Dr Pascal Lim was funded by a grant from the French Federation of Cardiology and the French Society of Cardiology. This work was also supported in part by the National Space Biomedical Research Institute through NASA NCC 9-58, the Department of Defense (Ft Dietrich, MD, USAMRMC Grant 02360007). This work is also supported in part by the National Institutes of Health, National Center for Research Resources, General Clinical Research Center Grant MO1 RR-018390.
PY - 2009/6
Y1 - 2009/6
N2 - Background: Myocardial dysfunction and left ventricular (LV) geometry deformation may reduce the accuracy of tissue Doppler imaging (TDI) in assessing myocardial contractility. Methods: In 92 patients with heart failure who underwent cardiac resynchronization therapy (CRT), we assessed the impact of LV end-diastolic volume on the accuracy of peak longitudinal velocity (TDI) and strain (ε{lunate}L by speckle tracking) to assess regional wall motion and LV dyssynchrony. Results: Peak-ε{lunate} correlated to normal (-13% ± 6%, n = 259), hypokinetic (-10% ± 5%, n = 347), and akinetic (-7% ± 5%, n = 498, P < .0001) wall motion independent of LV size. In contrast, velocity failed to distinguish normal from dysfunctional segments in patients with severe LV dilatation (end-diastolic volume > 250 mL). The 12 standard deviation of time to peak systolic velocity and the opposing septal-lateral wall delay by strain and TDI failed to predict response to CRT, whereas the 12 segment standard deviation of time to peak ε{lunate} correlated to end-systolic volume reduction (r = -0.39, P < .001). Conclusion: Accuracy of TDI in assessing LV wall regional motion is limited in severely dilated ventricles and probably affects LV dyssynchrony measurement.
AB - Background: Myocardial dysfunction and left ventricular (LV) geometry deformation may reduce the accuracy of tissue Doppler imaging (TDI) in assessing myocardial contractility. Methods: In 92 patients with heart failure who underwent cardiac resynchronization therapy (CRT), we assessed the impact of LV end-diastolic volume on the accuracy of peak longitudinal velocity (TDI) and strain (ε{lunate}L by speckle tracking) to assess regional wall motion and LV dyssynchrony. Results: Peak-ε{lunate} correlated to normal (-13% ± 6%, n = 259), hypokinetic (-10% ± 5%, n = 347), and akinetic (-7% ± 5%, n = 498, P < .0001) wall motion independent of LV size. In contrast, velocity failed to distinguish normal from dysfunctional segments in patients with severe LV dilatation (end-diastolic volume > 250 mL). The 12 standard deviation of time to peak systolic velocity and the opposing septal-lateral wall delay by strain and TDI failed to predict response to CRT, whereas the 12 segment standard deviation of time to peak ε{lunate} correlated to end-systolic volume reduction (r = -0.39, P < .001). Conclusion: Accuracy of TDI in assessing LV wall regional motion is limited in severely dilated ventricles and probably affects LV dyssynchrony measurement.
KW - Cardiac resynchronization therapy
KW - Speckle tracking
KW - Tissue Doppler
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U2 - 10.1016/j.echo.2009.04.015
DO - 10.1016/j.echo.2009.04.015
M3 - Article
C2 - 19501329
AN - SCOPUS:66549093151
VL - 22
SP - 695
EP - 701
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
SN - 0894-7317
IS - 6
ER -