title: Real-time three-dimensional echocardiographic evaluation of left ventricular systolic synchronicity in patients with chronic heart failure: comparison with tissue Doppler imaging.
abstract: BACKGROUND
  To investigate the clinical value of real-time three-dimensional echocardiography (RT-3DE) for assessing of left ventricular systolic synchronicity.
  
  
  METHODS
  Thirty healthy volunteers and 62 patients with congestive heart failure (CHF) were enrolled. The SD of time to peak systolic motion (TDI-Ts12-SD) was measured with tissue Doppler imaging in 12 myocardial segments. The SD and maximal difference of the time to minimal systolic volume (Tmsv) between 16, 12, or 6 myocardial segments, expressed as a percentage of cardiac cycle duration, were measured with RT-3DE and labeled Tmsv16-SD%, Tmsv12-SD%, Tmsv6-SD%, Tmsv16-D%, Tmsv12-D%, and Tmsv6-D%, respectively. The Spearman coefficient and Kappa value were calculated, and Bland-Altman analysis was performed to investigate the correlation and agreement between the two methods. Tmsv values were compared with ejection fraction (EF).
  
  
  RESULTS
  There was a moderately positive (p< 0.01) correlation between TDI-Ts12-SD and Tmsv16-SD%, Tmsv12-SD%, Tmsv16-D%, and Tmsv12-D% (r = 0.65, 0.64, and 0.65, respectively, with Kappa values of 0.66, 0.65, 0.72, and 0.74, respectively, p< 0.01). Tmsv16-SD%, Tmsv12-SD%, and Tmsv12-D% were significantly different between CHF patients with EF ≤ 35% and those with EF > 35%.
  
  
  CONCLUSIONS
  RT-3DE can be used in patients with CHF to quantify left ventricular mechanical dyssynchrony. Tmsv12-SD% and Tmsv12-D% were the best indices of left ventricular systolic synchronicity in relation to the severity of CHF as evaluated from EF.
authors.affiliation: Cardiovascular Disease Institute of Xuzhou Medical College, People's Republic of China.
authors.forename: Dong-ye
authors.initials: DY
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.forename: Guang-ke
authors.initials: GK
authors.lastname: Cao
authors.forename: Yong
authors.initials: Y
authors.lastname: Xia
authors.forename: Tong-da
authors.initials: TD
authors.lastname: Xu
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Wang
authors.forename: Jun-hong
authors.initials: JH
authors.lastname: Chen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013599:Systole; D018608:Ultrasonography, Doppler; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*