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

Pascal Lim, Laurens Mitchell-Heggs, Adisai Buakhamsri, James D. Thomas, Richard A. Grimm*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)695-701
Number of pages7
JournalJournal of the American Society of Echocardiography
Volume22
Issue number6
DOIs
StatePublished - Jun 2009

Keywords

  • Cardiac resynchronization therapy
  • Speckle tracking
  • Tissue Doppler

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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