title: Systolic time intervals as simple echocardiographic parameters of left ventricular systolic performance: correlation with ejection fraction and longitudinal two-dimensional strain.
abstract: OBJECTIVE
  Conventionally, the evaluation of left ventricular (LV) systolic function is based on ejection fraction assessment, which may be supplemented by other echocardiographic techniques, such as tissue Doppler imaging, 3D evaluation, and speckle tracking strains. However, these imaging modalities have a high technicity and are time-consuming, while being associated with reproducibility limitations. In this context, the usefulness of simpler measurements such as systolic time intervals (STI) by pulsed Doppler echocardiography must be emphasized.
  
  
  RESULTS
  In this multicentre study, left ventricular ejection fraction (LVEF), dP/dt(max), LV stroke volume, myocardial longitudinal deformation, aortic pre-ejectional period (PEP, ms), and left ventricular ejection time (LVET, ms) were prospectively investigated and compared in 134 consecutive heart failure (HF) patients and 43 control subjects. Feasibility of STI measurements was 100%. Intra-observer reproducibility was 98% for PEP, 96% for LVET, 87% for LVEF, and 93% for global longitudinal strain (GLS). By subgroup analyses, with increasingly altered LVEF or GLS, PEP significantly increased, whereas significantly LVET decreased, resulting in a significantly increased PEP/LVET ratio (P < 0.001). In the HF patients group, a correlation between LVEF and PEP/LVET was found, with r = 0.55 (y = -0.0083x + 0.75, P < 0.001). Based on receiver operating curve analyses, the area under the curve was 0.91 for PEP/LVET > 0.43, which allowed us to detect LVEF < 35% with a sensitivity of 87%, and a specificity of 84%.
  
  
  CONCLUSIONS
  STI can be easily and accurately measured in clinical practice, and may be used for detecting alterations in LV systolic function. Moreover, this method is likely to have potential applications in the management of HF patients.
authors.affiliation: Département de Cardiologie, CHU de Bordeaux, Université de Bordeaux, CIC-0005, Inserm U828, Plateforme Technologique d'Innovation Biomédicale, Bordeaux-Pessac, France. patricia.reant@chubordeaux.fr
authors.forename: Patricia
authors.initials: P
authors.lastname: Reant
authors.forename: Marina
authors.initials: M
authors.lastname: Dijos
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.forename: Aude
authors.initials: A
authors.lastname: Mignot
authors.forename: Philippe
authors.initials: P
authors.lastname: Ritter
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Pierre
authors.initials: P
authors.lastname: Dos Santos
authors.forename: Christophe
authors.initials: C
authors.lastname: Leclercq
authors.forename: Raymond
authors.initials: R
authors.lastname: Roudaut
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.forename: Stephane
authors.initials: S
authors.lastname: Lafitte
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013599:Systole / Q000502:physiology*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*