title: Apical transverse motion as surrogate parameter to determine regional left ventricular function inhomogeneities: a new, integrative approach to left ventricular asynchrony assessment.
abstract: OBJECTIVE
  Left ventricular (LV) asynchrony assessment is mostly based on delays between regional myocardial velocity peaks. Regional function is barely considered. We propose apical transverse motion (ATM) as a new parameter integrating both temporal and functional information, which was tested in different conduction delays.
  
  
  RESULTS
  We examined 67 patients, 11 patients with post-infarct ischaemic left bundle branch blocks (iLBBB) and 25 patients with non-ischaemic left bundle branch block (nLBBB), 12 patients with right bundle branch block (RBBB), and 19 normal healthy volunteers (NORM). Longitudinal colour tissue Doppler data were used to calculate the total transverse apex motion (ATM), the transverse motion in the four-chamber view plane alone (ATM(4CV)) as well as regional myocardial deformation and conventional LV asynchrony parameters. Median ATM was 1.8 mm in NORM, 1.5 mm in RBBB (P = 0.999), 2.4 mm in iLBBB (P = 0.183), and 4.3 mm in nLBBB (P < 0.001 vs. NORM and RSB). ATM(4CV) behaved similarly, showed a good correlation with regional deformation data, and distinguished well between NORM and LBBB (AUC = 0.87).
  
  
  CONCLUSIONS
  Apical transverse motion is a new and simple parameter integrating information on both regional and temporal function inhomogeneities of the LV. It has a potential role in assessing LV asynchrony in the clinical context.
authors.affiliation: Department of Cardiology, University Hospital Gasthuisberg, Cath. University Leuven, Herestraat 49, 3000 Leuven, Belgium. jens.uwe.voigt@gmx.net
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Voigt
authors.forename: Thomas-Michael
authors.initials: TM
authors.lastname: Schneider
authors.forename: Stephan
authors.initials: S
authors.lastname: Korder
authors.forename: Mariola
authors.initials: M
authors.lastname: Szulik
authors.forename: Emre
authors.initials: E
authors.lastname: Gürel
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Frank
authors.initials: F
authors.lastname: Rademakers
authors.forename: Frank A
authors.initials: FA
authors.lastname: Flachskampf
mesh_terms: D000368:Aged; D002037:Bundle-Branch Block / Q000503:physiopathology*; D016022:Case-Control Studies; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000503:physiopathology*; D015203:Reproducibility of Results; D013314:Stress, Mechanical; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology