Clinical evaluation of left ventricular systolic dyssynchrony among patients with coronary heart disease using two-dimensional speckle tracking imaging and three-dimensional echocardiography

The present study aimed to quantify left ventricular (LV) systolic dyssynchrony in patients with LV systolic dysfunction using a combined method of two-dimensional speckle imaging (2D-STI) and real-time three-dimensional echocardiography (RT-3DE). Totally, 26 myocardial infarction patients, 24 myocardial ischemia patients and 30 normal subjects were retrospectively reviewed. Their echocardiographic images were acquired by 2D-STI and RT-3DE. Time parameters of LV wall mechanics including times to peak longitudinal strain of 16 segments (Tls-16), to peak radial strain of 12 segments (Trs-12), to peak circumferential strain of 12 LV segments (Tcs-12), to peak rotation of 12 LV segments (Trot-12), and to peak rotation strain at the basal (Tbase) and apical (Tapex) levels were obtained from 2D-STI. Time to minimum systolic volume of 16 LV segments (Tmsv-16) was obtained from RT-3DE. Time differences between Tls and Tmsv (Tlsv), Trs and Tmsv (Trsv), Tcs and Tmsv (Tcsv), Trot and Tmsv (Trotv) and the time interval of rotation between apex and base (Tabrot) were calculated. The Tls-16, Tmsv-16 and Tlsv were prolonged in ischemia patients than control (P < 0.05). Compared with ischemia and control groups, all the time parameters were prolonged in infarction patients (P < 0.05). Tlsv, Trsv, Tcsv, Trotv and Tabrot had negative correlation with LV ejection fraction (LVEF) in infarction group. The relationship of LV wall mechanics with volume-time parameters could be used to evaluate LV systolic dys-synchrony in myocardial infarction. Besides, Tlsv could be applied on early detection of LV systolic dys-synchrony in ischemia patients.