Time movement timing parameters validation using tissue Doppler imaging in patients with dilated cardiomyopathy.
The aim of the study was to compare similar time-movement (TM) and tissue Doppler (TDI) timing parameters and to predict their value in assessment of systolic asynchrony for biventricular pacing indication.


METHODS
41 patients (pts) aged 56.4 +/- 11.2 years with dilated cardiomyopathy were included.


METHODS
QRS duration (QRSd); septal (S), posterior (P), lateral (L) and posterolateral (PL) wall delays, as the time from QRS onset to maximal wall contraction (parasternal, 4 chamber view and subcostal incidence); left ventricular mechanical delays (LVD) time interval from maximal contraction between interventricular septum and posterior (LVDp), lateral (LVD1) and posterolateral (LVDp1) wall, both in TM and TDI; TDI measurements were performed using both color and pulsed TDI (from onset of QRS to the end of S wave); isovolumic relaxation time (IRT) in each wall using TDI; An error parameter (Er) was assessed for each measurement as the difference in similar timing parameters TM-TDI.


RESULTS
LVDp = 111 +/- 69ms, LVD1 = 132 +/- 62ms, LVDp1 = 151 +/- 77ms; 26 pts presented QRSd > 120 ms (LBBB), 15 pts had QRSd < 120 ms. LVD > 100 ms was found in 32 pts; LVD were significantly higher in LBBB pts. There was no correlation between QRSd and echocardiographic parameters. Er ranged from 0-80 ms. Er > 30 ms were found in pts with fragmented wall motion and IRT > 30 ms. The most delayed wall was PL (42% pts), L (38%) and P (30%).


CONCLUSIONS
Intraventricular asynchronized contraction occurs even in pts with normal QRS duration; these changes can be easily and accurately detected using simple TM timing parameters. The most delayed site to be stimulated can be found either using TDI or TM.
Cozma
D
D
Institute of Cardiovascular Medicine, Timişoara, Romania. dragoscozmafr@yahoo.fr
Mornoş
C
C
Lighezan
D
D
Drăgulescu
S I
SI
D000368:Aged; D002304:Cardiac Pacing, Artificial; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D015150:Echocardiography, Doppler / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction; D013997:Time Factors