Assessment Of Left Ventricular Asynchrony In Patients With Heart Failure By Real-time Three-dimensional Echocardiography

ObjectiveTo quantitatively evaluate the left ventricular systolic synchronicity inpatients with chronic heart failure by real-time three-dimensional echocardiography(RT-3DE)MethodsThirty-two healthy volunteers and thirty-two patients with chronic heart failure were enrolled in this study.Full volume RT-3DE was performed using Philips IE33 with the the X3-1 matrix array 3D transducer and TDI imaging using the S5-1 2D transducer.The standard deviation of T_msv16-SD%that the 16 segments of end systolic time reaching minimal systolic volume,end-systolic volume(ESV), end-diastolic volume(EDV),left ventricular ejection fraction(LVEF),the 16 segments on volume-time curves can be measured by the Qlab software(5.0).and Time to peak sustained systolic velocities(Ts) can be measured by TDI,For assessment of left intraventricular contractive synchrony,the standard deviation of Ts (Ts-SD).Left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV) and left vent ricular end systolic volume(LVESV) were measured by Simpson'S modified biplane method.ResultsT_msv16-SD%was markedly higher in HF patients than in controls(8.6±4.5 vs 1.3±1.6 P＜0.01) and increased as LVEF^※decreased(r=-0.89,P＜0.01).Ts-SD was also significantly higher in HF patients(31.6±5.1 vs 14.5±5.3 P＜0.01) and had a good negative correlation with LVEF^※(r=-0.69,P＜0.01).T_msv16-SD%was well correlated to Ts-SD(r=0.76,P＜0.01).The LVEF determined by Simpson'S modified biplane method correlated closely with LVEF determined by RT-3DE(r=0.93, P＜0.001).ConclusionsRT-3DE can not only qualitation but also quantify global left ventricular asynchrony RT-3DE represents a novel technique to identify chronic heart failure patients who may otherwise not be considered for CRT.