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.