Assessment of left ventricular asynchrony using volume—time curves of 16 segments by real‐time 3 dimensional echocardiography: Comparison with tissue Doppler imaging

Background: Recent technical developments with high‐resolution real‐time 3 dimensional echocardiography (RT3DE) facilitate the acquisition of high quality images and the analysis of segmental volume—time curves (VTCs). Aims: To assess left ventricular (LV) asynchrony using the VTCs of 16 segments by RT3DE, and to evaluate accuracy compared to tissue Doppler imaging (TDI). Methods: Twenty‐three heart failure (HF) patients (LVEF: 25±6%, age: 60±13 years) and 16 normal controls underwent TDI and RT3DE. The standard deviation (SD 3 ) of the end systolic time reaching minimal systolic volume for the 16 segments on VTCs was obtained by RT3DE. The standard deviation (SD 2 ) of the electromechanical coupling time for the 8 segments was measured using TDI. Results: SD 3 was markedly higher in HF patients than in controls (7.7±2.5 vs 1.5±1.0%, P <0.01) and increased as LVEF decreased ( r =−0.85, P <0.01). SD 2 was also significantly higher in HF patients (27.0±8.6 vs 12.6±5.0 ms, P <0.01) and had a good negative correlation with LVEF ( r =−0.72, P <0.01). SD 3 was well correlated to SD 2 ( r =0.66, P <0.01). Conclusions: We suggest that analysis of VTCs in 16 segments using RT3DE may be a useful alternative to TDI for the evaluation of LV asynchrony.