Ventricular dyssynchrony index: comparison with two-dimensional and three-dimensional ejection fraction.
BACKGROUND
Left ventricular (LV) electromechanical coupling (synchrony) is important in the analysis of the systolic performance, especially for the indication of cardiac resynchronization therapy in patients with advanced CHF.


OBJECTIVE
To compare LV synchrony as analyzed by real-time three-dimensional (3D) echocardiography (ECHO) with LVEF measurements as obtained with 2D and 3D ECHO.


METHODS
Prospective study of 92 individuals (56 men, 47 +/- 10 years of age), of which 60 had normal heart structure (ECHO) and ECG (N group), and 32 had dilated cardiomyopathy (DCM group). Using 3D ECHO, LVEF, volumes and dyssynchrony index (%DI) for 16 LV segments were measured. Using 2D ECHO, LVEF (Simpson's method), and LV systolic and diastolic volumes were measured.


METHODS
Pearson's correlation coefficient, 95% CI, linear regression model, Bland & Altman analysis, p<0.05.


RESULTS
%DI ranged from 0.2900 to 28.1000 (5.2014+/-6.3281), 3D LVEF ranged from 0.17 to 0.81 (0.52+/-0.17); and 2D LVEF ranged from 0.3 to 0.69 (0.49+/-0.11). The correlation between DI and 3D LVEF was (r): -0.7432, p<0.0001, CI: -0.8227 to -0.6350, the linear relation between DI (x) and 3D LVEF (y) was y = 19.8124 + (-27.9578) x, p<0.0001. The correlation between DI and 2D LVEF was (r): -0.7012, p<0.0001, CI: -0.7923 to -0.5797.


CONCLUSIONS
In this case series, a good negative correlation was observed between LV electromechanical three-dimensional systolic coupling and LVEF as measured by echocardiography (3D and 2D).
Vieira
Marcelo L C
ML
Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Cury
Alexandre F
AF
Gustavo
Naccarato
N
Oliveira
Wercules A
WA
Monaco
Cláudia G
CG
Cordovil
Adriana
A
Rodrigues
Ana C T
AC
Lira Filho
Edgar B
EB
Fischer
Cláudio H
CH
Morhy
Samira S
SS
D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*