Comparison of echocardiographic dyssynchrony assessment by tissue velocity and strain imaging in subjects with or without systolic dysfunction and with or without left bundle-branch block

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Background Several echocardiographic dyssynchrony indexes have been proposed to identify responders to cardiac resynchronization therapy using tissue velocity and strain. The present study aimed to compare tissue velocity- derived and strain-derived dyssynchrony indexes in patients with or without systolic dysfunction and left bundle-branch block. Methods and Results Tissue Doppler imaging was performed in 120 subjects divided into 4 groups: group 1 (n=40), normal subjects; group 2 (n=20), normal left ventricular ejection fraction and left bundle-branch block; group 3 (n=20), left ventricular ejection fraction <35% and normal conduction; and group 4 (n=40), left ventricular ejection fraction <35% and left bundle-branch block. Dyssynchrony indexes based on time to peak tissue velocity (septal-lateral delay, anteroseptal-posterior delay, and SD in time to peak systolic velocity in the 12 left ventricular segments) and strain (SD of time to peak strain in 12 segments) were measured. The SD in time to peak systolic velocity in the 12 left ventricular segments was greater in group 4 (54 ms; 25th and 75th percentiles, 46 to 64 ms) than group 1 (44 ms; 25th and 75th percentiles, 28 to 53 ms; P=0.006), but there was a considerable overlap of all tissue velocity- derived indexes among 4 groups, with 40% to 68% of group 1 having values proposed for predicting the responders of cardiac resynchronization therapy. The SD of time to peak strain in 12 segments distinguished these groups with much less overlap (P<0.01 for all pairwise comparisons). Conclusions A substantial proportion of normal subjects have tissue velocity- derived dyssynchrony indexes higher than the cutoff value proposed for predicting beneficial effect of cardiac resynchronization therapy. Strain-derived timing index appears to be more specific for dyssynchrony in patients with systolic dysfunction and left bundle-branch block. Identifying an optimal tissue velocity- or strain-derived dyssynchrony index requires a large prospective clinical trial. Circulation. 2008;117:2617-2625.)

Original languageEnglish (US)
Pages (from-to)2617-2625
Number of pages9
JournalCirculation
Volume117
Issue number20
DOIs
StatePublished - May 20 2008

Fingerprint

Bundle-Branch Block
Cardiac Resynchronization Therapy
Stroke Volume
Clinical Trials

Keywords

  • Bundle-branch block
  • Conduction
  • Dyssynchrony
  • Echocardiography
  • Heart failure

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{ec31ba814957462b8f51a622b45b6454,
title = "Comparison of echocardiographic dyssynchrony assessment by tissue velocity and strain imaging in subjects with or without systolic dysfunction and with or without left bundle-branch block",
abstract = "Background Several echocardiographic dyssynchrony indexes have been proposed to identify responders to cardiac resynchronization therapy using tissue velocity and strain. The present study aimed to compare tissue velocity- derived and strain-derived dyssynchrony indexes in patients with or without systolic dysfunction and left bundle-branch block. Methods and Results Tissue Doppler imaging was performed in 120 subjects divided into 4 groups: group 1 (n=40), normal subjects; group 2 (n=20), normal left ventricular ejection fraction and left bundle-branch block; group 3 (n=20), left ventricular ejection fraction <35{\%} and normal conduction; and group 4 (n=40), left ventricular ejection fraction <35{\%} and left bundle-branch block. Dyssynchrony indexes based on time to peak tissue velocity (septal-lateral delay, anteroseptal-posterior delay, and SD in time to peak systolic velocity in the 12 left ventricular segments) and strain (SD of time to peak strain in 12 segments) were measured. The SD in time to peak systolic velocity in the 12 left ventricular segments was greater in group 4 (54 ms; 25th and 75th percentiles, 46 to 64 ms) than group 1 (44 ms; 25th and 75th percentiles, 28 to 53 ms; P=0.006), but there was a considerable overlap of all tissue velocity- derived indexes among 4 groups, with 40{\%} to 68{\%} of group 1 having values proposed for predicting the responders of cardiac resynchronization therapy. The SD of time to peak strain in 12 segments distinguished these groups with much less overlap (P<0.01 for all pairwise comparisons). Conclusions A substantial proportion of normal subjects have tissue velocity- derived dyssynchrony indexes higher than the cutoff value proposed for predicting beneficial effect of cardiac resynchronization therapy. Strain-derived timing index appears to be more specific for dyssynchrony in patients with systolic dysfunction and left bundle-branch block. Identifying an optimal tissue velocity- or strain-derived dyssynchrony index requires a large prospective clinical trial. Circulation. 2008;117:2617-2625.)",
keywords = "Bundle-branch block, Conduction, Dyssynchrony, Echocardiography, Heart failure",
author = "Chinami Miyazaki and Powell, {Brian D.} and Bruce, {Charles J} and Espinosa, {Raul Emilio} and Redfield, {Margaret May} and Miller, {Fletcher A Jr.} and Hayes, {David L.} and Yong-Mei Cha and Oh, {Jae Kuen}",
year = "2008",
month = "5",
day = "20",
doi = "10.1161/CIRCULATIONAHA.107.733675",
language = "English (US)",
volume = "117",
pages = "2617--2625",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "20",

}

TY - JOUR

T1 - Comparison of echocardiographic dyssynchrony assessment by tissue velocity and strain imaging in subjects with or without systolic dysfunction and with or without left bundle-branch block

AU - Miyazaki, Chinami

AU - Powell, Brian D.

AU - Bruce, Charles J

AU - Espinosa, Raul Emilio

AU - Redfield, Margaret May

AU - Miller, Fletcher A Jr.

AU - Hayes, David L.

AU - Cha, Yong-Mei

AU - Oh, Jae Kuen

PY - 2008/5/20

Y1 - 2008/5/20

N2 - Background Several echocardiographic dyssynchrony indexes have been proposed to identify responders to cardiac resynchronization therapy using tissue velocity and strain. The present study aimed to compare tissue velocity- derived and strain-derived dyssynchrony indexes in patients with or without systolic dysfunction and left bundle-branch block. Methods and Results Tissue Doppler imaging was performed in 120 subjects divided into 4 groups: group 1 (n=40), normal subjects; group 2 (n=20), normal left ventricular ejection fraction and left bundle-branch block; group 3 (n=20), left ventricular ejection fraction <35% and normal conduction; and group 4 (n=40), left ventricular ejection fraction <35% and left bundle-branch block. Dyssynchrony indexes based on time to peak tissue velocity (septal-lateral delay, anteroseptal-posterior delay, and SD in time to peak systolic velocity in the 12 left ventricular segments) and strain (SD of time to peak strain in 12 segments) were measured. The SD in time to peak systolic velocity in the 12 left ventricular segments was greater in group 4 (54 ms; 25th and 75th percentiles, 46 to 64 ms) than group 1 (44 ms; 25th and 75th percentiles, 28 to 53 ms; P=0.006), but there was a considerable overlap of all tissue velocity- derived indexes among 4 groups, with 40% to 68% of group 1 having values proposed for predicting the responders of cardiac resynchronization therapy. The SD of time to peak strain in 12 segments distinguished these groups with much less overlap (P<0.01 for all pairwise comparisons). Conclusions A substantial proportion of normal subjects have tissue velocity- derived dyssynchrony indexes higher than the cutoff value proposed for predicting beneficial effect of cardiac resynchronization therapy. Strain-derived timing index appears to be more specific for dyssynchrony in patients with systolic dysfunction and left bundle-branch block. Identifying an optimal tissue velocity- or strain-derived dyssynchrony index requires a large prospective clinical trial. Circulation. 2008;117:2617-2625.)

AB - Background Several echocardiographic dyssynchrony indexes have been proposed to identify responders to cardiac resynchronization therapy using tissue velocity and strain. The present study aimed to compare tissue velocity- derived and strain-derived dyssynchrony indexes in patients with or without systolic dysfunction and left bundle-branch block. Methods and Results Tissue Doppler imaging was performed in 120 subjects divided into 4 groups: group 1 (n=40), normal subjects; group 2 (n=20), normal left ventricular ejection fraction and left bundle-branch block; group 3 (n=20), left ventricular ejection fraction <35% and normal conduction; and group 4 (n=40), left ventricular ejection fraction <35% and left bundle-branch block. Dyssynchrony indexes based on time to peak tissue velocity (septal-lateral delay, anteroseptal-posterior delay, and SD in time to peak systolic velocity in the 12 left ventricular segments) and strain (SD of time to peak strain in 12 segments) were measured. The SD in time to peak systolic velocity in the 12 left ventricular segments was greater in group 4 (54 ms; 25th and 75th percentiles, 46 to 64 ms) than group 1 (44 ms; 25th and 75th percentiles, 28 to 53 ms; P=0.006), but there was a considerable overlap of all tissue velocity- derived indexes among 4 groups, with 40% to 68% of group 1 having values proposed for predicting the responders of cardiac resynchronization therapy. The SD of time to peak strain in 12 segments distinguished these groups with much less overlap (P<0.01 for all pairwise comparisons). Conclusions A substantial proportion of normal subjects have tissue velocity- derived dyssynchrony indexes higher than the cutoff value proposed for predicting beneficial effect of cardiac resynchronization therapy. Strain-derived timing index appears to be more specific for dyssynchrony in patients with systolic dysfunction and left bundle-branch block. Identifying an optimal tissue velocity- or strain-derived dyssynchrony index requires a large prospective clinical trial. Circulation. 2008;117:2617-2625.)

KW - Bundle-branch block

KW - Conduction

KW - Dyssynchrony

KW - Echocardiography

KW - Heart failure

UR - http://www.scopus.com/inward/record.url?scp=47649122907&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47649122907&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.107.733675

DO - 10.1161/CIRCULATIONAHA.107.733675

M3 - Article

VL - 117

SP - 2617

EP - 2625

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 20

ER -