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Time movement timing parameters validation using tissue Doppler imaging in patients with dilated cardiomyopathy
D Cozma1, C Mornoş, D Lighezan
1Institute of Cardiovascular Medicine, Timişoara, Romania. dragoscozmafr@yahoo.fr
Summary
Simple time-movement (TM) and tissue Doppler (TDI) parameters accurately detect systolic asynchrony in patients with dilated cardiomyopathy, even those with normal QRS duration, guiding biventricular pacing. The most delayed wall can be identified using either TM or TDI.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Electrophysiology
Background:
- Systolic asynchrony is a key factor in heart failure and a target for biventricular pacing.
- Accurate assessment of asynchrony is crucial for optimizing pacing therapy.
Purpose of the Study:
- To compare time-movement (TM) and tissue Doppler imaging (TDI) parameters for assessing systolic asynchrony.
- To evaluate the utility of these parameters in identifying candidates for biventricular pacing.
Main Methods:
- 41 patients with dilated cardiomyopathy underwent echocardiographic assessment.
- Evaluated septal, posterior, lateral, and posterolateral wall delays using TM and TDI.
- Measured left ventricular mechanical delays (LVD) and assessed an error parameter (Er) for TM-TDI comparison.
Main Results:
- Left ventricular mechanical delays (LVD) exceeding 100 ms were found in 32 patients, significantly higher in those with LBBB.
- No correlation was observed between QRS duration and echocardiographic parameters.
- The posterolateral wall was the most frequently delayed segment (42% of patients).
Conclusions:
- Intraventricular asynchrony is present even in patients with normal QRS duration.
- Simple TM timing parameters effectively detect these changes.
- Both TDI and TM can identify the most delayed myocardial segments for pacing.
