Introduction
Echo-physiological principles and rationale
Left ventricular time intervals and atrioventricular dyssynchrony
Interventricular dyssynchrony
Measurements of regional intraventricular dyssynchrony
Author (Ref.) | Parameter |
N
| Population | Ischemic etiology (%) | Follow-up (months) | Response | Cut-off | Sensitivity (%)/specificity (%) |
---|---|---|---|---|---|---|---|---|
Pitzalis [14] | SPWMD | 20 | NYHA III, QRS ≥ 140 ms, LVEF ≤ 35%, SR, LBBB | 20 | 1 | LVESV ≥ 15% | 130 ms | 100/63 |
Soliman [50] | 3D-SDI | 90 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35%, SR | 51 | 12 | LVESV ≥ 15% | >10% | 96/88 |
Bax [12] | Ts-4 | 80 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35%, SR, LBBB | 55 | 6 | LVESV ≥ 15% | 65 ms | 92/92 |
NYHA ≥ 1 | 65 ms | 80/80 | ||||||
Yu [56] | Ts-SD12 | 30 | NYHA III, QRS ≥ 140 ms, LVEF ≤ 40% | 40 | 3 | LVESV ≥ 15% | 32.6 ms | 100/100 |
Yu [16] | TSI-Ts-SD12 | 56 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 40% | 50 | 3 | LVESV ≥ 15% | 34.4 ms | 87/81 |
Suffoletto [15] | 2D-RS | 50 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35%, SR | 62 | 8 ± 5 | LVEF ≥ 15% | 130 ms | 89/83 |
Quantification based on tissue motion or tissue velocity delays
One-dimensional techniques assessing motion delay
Three-dimensional motion delays
Tissue velocity delays
General limitations of motion- and velocity-based techniques
Quantification based on tissue deformation delays
Considerations and limitations regarding regional temporal dyssynchrony
Assessment of mechanical dyscoordination and inefficiency
Qualitative appraisal of discoordination-related motion features
Author (Ref.) | Parameter |
N
| Population | Ischemic etiology (%) | Follow-up (months) | Response | Cut-off | Sensitivity (%)/specificity (%) | Other results |
---|---|---|---|---|---|---|---|---|---|
Visual appraisal
| |||||||||
Jansen [71] | Shuffle and septal motion | 53 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35%, SR, LBBB | 49 | 3 | LVESV ≥ 10% | NA | 91/76 | |
Phase analysis
| |||||||||
Buss [74] | EPI | 42 | NYHA ≥ III, QRS ≥ 130 ms, LVEF ≤ 35% | 43 | 6–8 | LVESV ≥ 15% | 59% | 88/75 | Ts-SD performed similar |
LVEF ≥ 8% | 59% | 95/67 | |||||||
Bilchicka [72] | TUScirc | 20 CRT | CRT: NYHA III, clinical recommendation for CRT | 40 | 6 | NYHA ≥ 1 | 0.75 | 100/71 | TDI septal-to-lateral delay indicated dyssynchrony in 44% of controls whereas TUS was normal |
27 heterogeneous | |||||||||
9 control | |||||||||
Bertola [77] | TUScirc | 68 | Heart failure, QRS ≥ 120 ms, LVEF ≤ 35% | 43 | 3–6 | LVESV ≥ 15% and LVEF ≥ 25% | 0.52 | 56/63 | TUS improved after CRT, 2DS-SD did not change |
Ascione [78] | RGDI | 62 CRT | CRT: NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35%, SR | 44 | 6 | LVESV ≥ 15% | 47% | 87/74 | Ts-SD had more overlap between responders and non-responders, RGDI and LGDI were lower in controls |
15 control | |||||||||
LGDI | 34% | 82/74 | |||||||
Stretch relative to shortening
| |||||||||
Kirna [24] | ISF | 19 CRT | – | 47 | 3 | LVESV ≥ 15% | – | – | Only baseline ISF differed between responders and non-responders, baseline onset or peak variance was different from controls but did not differentiate responders |
9 control | |||||||||
Wang [79] | ISF | 30 CRT | CRT: NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35% | CRT: 40 | 0 and 6 | LVESV ≥ 15% | 40% | 94/67 | Acute ISF reduction provided the best prediction of CRT response compared to acute improvement in temporal parameters and baseline ISF |
40 narrow | HF: 50 | ||||||||
QRS HF | |||||||||
20 control | HF: LVEF ≤ 35% | ||||||||
Selective quantification of inefficient deformation
| |||||||||
De Boeck [80] | SRSsept | 62 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35% | 44 | 6.5 ± 2.3 | LVESV ≥ 15% | 4.7% | 81/81 | SRS conversion into additional shortening correlated with improvements in LVEF |
Lim [85] | Strain-delay | 100 | NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35% | 35 | 3 | LVESV ≥ 15% | 25% | 82/92 | Temporal velocity indices did not differentiate responders, temporal 2DS indices did not correlate with reverse remodeling in patients with ischemic etiology of HF |
Abe [86] | FIC | 9 CRT | CRT: NYHA ≥ III, QRS ≥ 120 ms, LVEF ≤ 35%, SR | CRT: 33 | NA | – | – | – | FIC was larger in CRT compared to non-CRT candidates, 2DS-SD did not differ between those groups |
31 non-CRT HF | HF: 48 | ||||||||
20 control | |||||||||
HF: LVEF ≤ 35%, SR |