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Test-re-test reproducibility of Doppler echocardiography for assessment of electromechanical dyssynchrony: implications for heart failure clinic.

Authors :
Palmieri V
Russo C
Buonomo A
Cimmino G
Tartaglione D
Pezzullo S
Celentano A
Source :
Journal of cardiology [J Cardiol] 2010 Nov; Vol. 56 (3), pp. 271-9. Date of Electronic Publication: 2010 Jul 16.
Publication Year :
2010

Abstract

Background: Reproducibility of Doppler echocardiography for assessment of inter-ventricular and intra-left ventricular (LV) dyssynchrony, and its clinical implications, have not been established.<br />Methods: Twenty-eight subjects (heart failure stages A-C, 61% with QRS ≥ 120 ms, ejection fraction (EF) ≤ 35%) underwent two consecutive echo-studies within 24h to evaluate test-re-test reproducibility of inter-ventricular electromechanical delay (VV delay, by traditional pulsed-Doppler), and intra-LV electromechanical delay between opposite LV walls by color-coded Doppler tissue-velocity (COLOR-DTI), and by pulsed-Doppler tissue spectrum (PW-DTI). Reproducibility of LV internal diastolic diameter (LVIDD) and of EF (by Simpson's method) assessments was evaluated contextually for reference.<br />Results: Intra-study and inter-study reproducibility of inter-ventricular and intra-LV electromechanical dyssynchrony was in general good, and comparable to the reproducibility of LVIDD and EF assessments. Between-study reproducibility of PW-TDI method was fair, but showed poor agreement with COLOR-TDI method. In repeated studies, agreement of significant electromechanical delay by COLOR-TDI was comparable to the agreement of EF ≤ 35%. In the 5 patients who had simultaneously large QRS, EF ≤ 35%, and significant inter- and intra-ventricular dyssynchrony at study #1, 3 had EF 36-40% and 1 showed no significant dyssynchrony by study #2.<br />Conclusion: In serial echocardiographic studies, Doppler echocardiography showed a good test-re-test reproducibility for the identification of significant electromechanical delay. Planimetry for EF assessment was a source of variability as relevant as Doppler echocardiography, but COLOR-DTI may add meaningful and reproducible information to QRS duration for cardiac-resynchronization therapy.<br /> (Copyright © 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1876-4738
Volume :
56
Issue :
3
Database :
MEDLINE
Journal :
Journal of cardiology
Publication Type :
Academic Journal
Accession number :
20637569
Full Text :
https://doi.org/10.1016/j.jjcc.2010.06.002