Quantification of left ventricular asynchrony throughout the whole cardiac cycle with a computed algorithm: application for optimizing resynchronization therapy.

Introduction: Measurement of left ventricular (LV) asynchrony is usually determined on single time points from spectral tissue Doppler imaging (TDI) scans that are frequently difficult to identify or not representative of the whole cardiac cycle. Our aim was to validate a new asynchrony index that e...

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Published in:Journal of Cardiovascular Electrophysiology Vol. 20; no. 10; pp. 1130 - 1137
Main Authors: Silva E, Sitges M, Mont L, Delgado V, Tamborero D, Vidal B, Godoy M, Poyatos S, Pare C, Azqueta M, Brugada J
Format: algorithm equations & formulas research tables/charts Journal Article
Published: Wiley-Blackwell Oct2009
Online Access:View this record in EBSCOhost
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      dt: Oct2009
      vid: 20
      iid: 10
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        105324710
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        10.1111/j.1540-8167.2009.01507.x
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        atl: Quantification of left ventricular asynchrony throughout the whole cardiac cycle with a computed algorithm: application for optimizing resynchronization therapy.
      aug:
        au:
          Silva E
          Sitges M
          Mont L
          Delgado V
          Tamborero D
          Vidal B
          Godoy M
          Poyatos S
          Pare C
          Azqueta M
          Brugada J
      sug:
        subj:
          Arrhythmia, Ventricular
          Defibrillators, Implantable
          Heart Failure
          Heart Ventricle, Left
          Algorithms
          Data Analysis Software
          Demography
          Echocardiography
          kappa Statistic
          Mann-Whitney U Test
          ROC Curve
          Sensitivity and Specificity
          Spain
          T-Tests
          Wilcoxon Rank Sum Test
          Human
      ab: Introduction: Measurement of left ventricular (LV) asynchrony is usually determined on single time points from spectral tissue Doppler imaging (TDI) scans that are frequently difficult to identify or not representative of the whole cardiac cycle. Our aim was to validate a new asynchrony index that evaluates the motion of the LV walls throughout the whole cardiac cycle. Methods and Results: Ten healthy volunteers and 50 patients undergoing cardiac resynchronization therapy (CRT) were studied with TDI. Wall displacement tracings from the septal and lateral LV walls were analyzed. Cross-correlation was calculated and 2 indices were obtained to assess LV asynchrony: the time delay and the superposition index (SI) between wall displacements. These results were compared between healthy volunteers and CRT patients, and between responders and nonresponders to CRT. Also, the optimal interventricular (VV) interval was based upon the best matching level. Volunteers showed lower asynchrony indices (83 ± 2% SI, 17 ± 8 ms time delay) as compared with CRT patients (63 ± 15% SI, 73 ± 60 ms time delay, P < 0.05). Responders also had more LV dyssynchrony than nonresponders (58 ± 15% SI and 92 ± 66 ms vs 68 ± 12% and 48 ± 34 ms, P < 0.05). The optimum VV interval selected by the computed algorithm showed an excellent concordance (Kappa = 0.90, P < 0.05) with that determined by other validated methods for optimizing the programming of CRT devices. Conclusions: This approach allows measurement of LV intraventricular asynchrony throughout the cardiac cycle, being useful to determine the optimum VV interval and to select candidates for CRT.
      pubtype: Academic Journal
      doctype:
        algorithm
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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