The Feasibility of 3D Echocardiography Examination for Determining the Left Ventricular Dyssynchrony Index: A Pilot Study
Abstract
Background: Three-dimensional echocardiography (3DE) allows simultaneous evaluation of the entire left ventricular (LV) volume, motion, and mechanical dyssynchrony. This study aimed to provide valuable data on the feasibility and reliability of 3DE in assessing LV dyssynchrony in healthy individuals.
Methods: One hundred healthy volunteers, including both genders, with mean age, weight, and BMI of 39.64±10.21 years, 76.57±14.65 kg, and 27.59±4.3 kg.m-2, respectively, without evidence of structural heart or chronic disease, were included. 3DE examinations were conducted using a 4-chamber view and the full-volume method for all volunteers. Dyssynchrony was automatically quantified as the systolic dyssynchrony index (SDI) for selected LV segments using Q-lab software. The standard deviation (SD) of the time to attain minimum systolic volume was considered as SDI. This time length was expressed as % R-R to compensate for the variability of heart rate and increase reproducibility. Consequently, a single SDI (global SDI) was available for quantifying the degree of LV dyssynchrony by comparing all segments.
Results: According to echocardiographic findings, the mean global LV-SDI, apical SDI, basal SDI, and mid SDI were 28.68±15.48 msec, 26.16±27.47 msec, 24.41±14.35 msec, and 22.07±18.24 msec, respectively. After correction for RR duration, the mean global LV-SDI was 3.49±1.97%, apical SDI: 3.21±3.58%, basal SDI: 2.97±1.82%, and mid SDI: 2.68±2.19%.
Conclusion: 3DE proves to be a useful tool for evaluating LV dyssynchrony. The data provided include age- and sex-related changes in total and regional SDI in healthy volunteers, serving as a suitable reference for further investigations into LV dyssynchrony changes.
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29- Nina Ajmone Marsan et al., "Real‐time three‐dimensional echocardiography permits quantification of left ventricular mechanical dyssynchrony and predicts acute response to cardiac resynchronization therapy." Journal of cardiovascular electrophysiology, Vol. 19 (No. 4), pp. 392-99, (2008).
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31- Frantisek Straka et al., "A Pilot Study of Systolic Dyssynchrony Index by Real Time Three‐Dimensional Echocardiography and Doppler Tissue Imaging Parameters Predicting the Hemodynamic Response to Biventricular Pacing in the Early Postoperative Period after Cardiac Surgery." Echocardiography, Vol. 29 (No. 7), pp. 827-39, (2012).
32- Rahul Mehrotra, "Three-dimensional echocardiographic systolic dyssynchrony index-what is the correct cut-off?" Indian Heart Journal, Vol. 70 (No. 5), p. 765, (2018).
33- Vasileios Sachpekidis, Amit Bhan, and Mark J Monaghan, "Three Dimensional Echocardiographic Evaluation of LV Dyssynchrony and Stress Testing." in Textbook of Real-Time Three Dimensional Echocardiography: Springer, (2010), pp. 63-80.
34- Haiyong Wang, Yan Song, Jingjing Mu, Jing Shang, Jiabing Wang, and Litao Ruan, "Left ventricular systolic dyssynchrony in patients with Kawasaki disease: a real-time three-dimensional echocardiography study." The International Journal of Cardiovascular Imaging, Vol. 36pp. 1941-51, (2020).
2- Islam Y Elgendy, Dhruv Mahtta, and Carl J Pepine, "Medical therapy for heart failure caused by ischemic heart disease." Circulation research, Vol. 124 (No. 11), pp. 1520-35, (2019).
3- Ali Tarighatnia, Asghar Mesbahi, Amir Hossein Mohammad Alian, Evin Koleini, and Nader Nader, "An analysis of operating physician and patient radiation exposure during radial coronary angioplasties." Radiation protection dosimetry, Vol. 182 (No. 2), pp. 200-07, (2018).
4- Sherif F Nagueh, "Left ventricular diastolic function: understanding pathophysiology, diagnosis, and prognosis with echocardiography." JACC: Cardiovascular Imaging, Vol. 13 (No. 1 Part 2), pp. 228-44, (2020).
5- Dawud Abawi et al., "The non-invasive assessment of myocardial work by pressure-strain analysis: clinical applications." Heart Failure Reviews, Vol. 27 (No. 4), pp. 1261-79, (2022).
6- Sherif F Nagueh, "Non‐invasive assessment of left ventricular filling pressure." European journal of heart failure, Vol. 20 (No. 1), pp. 38-48, (2018).
7- Ali Tarighatnia, Gurkaran Johal, Ayuob Aghanejad, Hossein Ghadiri, and Nader D Nader, "Tips and tricks in molecular imaging: a practical approach." Frontiers in Biomedical Technologies, Vol. 8 (No. 3), pp. 226-35, (2021).
8- Lars Gunnar Klaeboe and Thor Edvardsen, "Echocardiographic assessment of left ventricular systolic function." Journal of echocardiography, Vol. 17pp. 10-16, (2019).
9- Maria Concetta Pastore et al., "Basic and advanced echocardiography in advanced heart failure: an overview." Heart Failure Reviews, Vol. 25pp. 937-48, (2020).
10- Ziyu Wang, Yongquan Wu, and Junmeng Zhang, "Cardiac resynchronization therapy in heart failure patients: tough road but clear future." Heart Failure Reviews, Vol. 26 (No. 3), pp. 735-45, (2021).
11- Laura R Bear, Peter R Huntjens, Richard D Walton, Olivier Bernus, Ruben Coronel, and Rémi Dubois, "Cardiac electrical dyssynchrony is accurately detected by noninvasive electrocardiographic imaging." Heart rhythm, Vol. 15 (No. 7), pp. 1058-69, (2018).
12- Raymond Pranata, Emir Yonas, Rachel Vania, Alexander Edo Tondas, and Yoga Yuniadi, "Fragmented QRS is associated with intraventricular dyssynchrony and independently predicts nonresponse to cardiac resynchronization therapy—systematic review and meta‐analysis." Annals of Noninvasive Electrocardiology, Vol. 25 (No. 4), p. e12750, (2020).
13- Amit Noheria, Sandeep Sodhi, and G Joseph Orme, "The evolving role of electrocardiography in cardiac resynchronization therapy." Current Treatment Options in Cardiovascular Medicine, Vol. 21pp. 1-14, (2019).
14- George Bazoukis et al., "Association of QRS narrowing with response to cardiac resynchronization therapy—A systematic review and meta-analysis of observational studies." Heart Failure Reviews, Vol. 25pp. 745-56, (2020).
15- VA Kuznetsov, AM Soldatova, JD Kasprzak, DV Krinochkin, and NN Melnikov, "Echocardiographic markers of dyssynchrony as predictors of super-response to cardiac resynchronisation therapy–a pilot study." Cardiovascular ultrasound, Vol. 16pp. 1-7, (2018).
16- Lang Gao et al., "Clinical utility of three-dimensional speckle-tracking echocardiography in heart failure." Journal of Clinical Medicine, Vol. 11 (No. 21), p. 6307, (2022).
17- WN Lee, Y Zhang, and H Li, "A novel high quality ultrafast ultrasound imaging method for mapping heart dynamics." Abstracts--Poster Session--Poster session, Vol. 6p. i1211, (2019).
18- Jens-Uwe Voigt and Marta Cvijic, "2-and 3-dimensional myocardial strain in cardiac health and disease." JACC: Cardiovascular Imaging, Vol. 12 (No. 9), pp. 1849-63, (2019).
19- Osama II Soliman et al., "Quantification of left ventricular systolic dyssynchrony by real-time three-dimensional echocardiography." Journal of the American Society of Echocardiography, Vol. 22 (No. 3), pp. 232-39, (2009).
20- Andrada C Guta et al., "Three-dimensional echocardiography to assess left ventricular geometry and function." Expert Review of Cardiovascular Therapy, Vol. 17 (No. 11), pp. 801-15, (2019).
21- Denisa Muraru, Alice Niero, Hugo Rodriguez-Zanella, Diana Cherata, and Luigi Badano, "Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging." Cardiovascular diagnosis and therapy, Vol. 8 (No. 1), p. 101, (2018).
22- Masaaki Takeuchi, Karima Addetia, and Roberto M Lang, "Advanced Assessment of the Left Ventricle." Textbook of Three-Dimensional Echocardiography, pp. 73-86, (2019).
23- Victoria Delgado et al., "Assessment of left ventricular dyssynchrony by real-time three-dimensional echocardiography." Revista Española de Cardiología (English Edition), Vol. 61 (No. 8), pp. 825-34, (2008).
24- Bing Xing, Ailin Cao, Wei Sun, and Xiyan Hou, "Relationship between left ventricular diastolic dyssynchrony and systolic dyssynchrony in hypertrophic cardiomyopathy by single-cardiac real-time three-dimensional ultrasonography." Experimental and Therapeutic Medicine, Vol. 15 (No. 4), pp. 3769-74, (2018).
25- Roberto M Lang et al., "EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography." European Heart Journal–Cardiovascular Imaging, Vol. 13 (No. 1), pp. 1-46, (2012).
26- Victor Mor-Avi et al., "Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error." JACC: Cardiovascular Imaging, Vol. 1 (No. 4), pp. 413-23, (2008).
27- S Kapetanakis, MT Kearney, A Siva, N Gall, M Cooklin, and MJ Monaghan, "Real-time three-dimensional echocardiography: a novel technique to quantify global left ventricular mechanical dyssynchrony." Circulation, Vol. 112 (No. 7), pp. 992-1000, (2005).
28- Jae-Hyeong Park, "Two-dimensional echocardiographic assessment of myocardial strain: important echocardiographic parameter readily useful in clinical field." Korean Circulation Journal, Vol. 49 (No. 10), p. 908, (2019).
29- Nina Ajmone Marsan et al., "Real‐time three‐dimensional echocardiography permits quantification of left ventricular mechanical dyssynchrony and predicts acute response to cardiac resynchronization therapy." Journal of cardiovascular electrophysiology, Vol. 19 (No. 4), pp. 392-99, (2008).
30- Sebastiaan A Kleijn et al., "A meta-analysis of left ventricular dyssynchrony assessment and prediction of response to cardiac resynchronization therapy by three-dimensional echocardiography." European Heart Journal–Cardiovascular Imaging, Vol. 13 (No. 9), pp. 763-75, (2012).
31- Frantisek Straka et al., "A Pilot Study of Systolic Dyssynchrony Index by Real Time Three‐Dimensional Echocardiography and Doppler Tissue Imaging Parameters Predicting the Hemodynamic Response to Biventricular Pacing in the Early Postoperative Period after Cardiac Surgery." Echocardiography, Vol. 29 (No. 7), pp. 827-39, (2012).
32- Rahul Mehrotra, "Three-dimensional echocardiographic systolic dyssynchrony index-what is the correct cut-off?" Indian Heart Journal, Vol. 70 (No. 5), p. 765, (2018).
33- Vasileios Sachpekidis, Amit Bhan, and Mark J Monaghan, "Three Dimensional Echocardiographic Evaluation of LV Dyssynchrony and Stress Testing." in Textbook of Real-Time Three Dimensional Echocardiography: Springer, (2010), pp. 63-80.
34- Haiyong Wang, Yan Song, Jingjing Mu, Jing Shang, Jiabing Wang, and Litao Ruan, "Left ventricular systolic dyssynchrony in patients with Kawasaki disease: a real-time three-dimensional echocardiography study." The International Journal of Cardiovascular Imaging, Vol. 36pp. 1941-51, (2020).
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1.
Aliakbarzadeh P, Khezerlouy Aghdam N, Toufan M. The Feasibility of 3D Echocardiography Examination for Determining the Left Ventricular Dyssynchrony Index: A Pilot Study. Frontiers Biomed Technol. 2024;.
