Related Experiment Video
Updated: Jun 28, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Novel method for displaying left ventricular function and dyssynchrony using tissue Doppler imaging: evaluation of
Takahide Ito1, Yasunori Kawanishi, Bin Tsukada
1Third Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan. in3016@poh.osaka-med.ac.jp
Insights
A novel Doppler tissue imaging method effectively displays left ventricular (LV) function and dyssynchrony in dilated cardiomyopathy patients. This technique allows quick assessment of LV mechanical dyssynchrony, aiding in clinical evaluations.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Dilated cardiomyopathy (DCM) presents challenges in assessing left ventricular (LV) function and mechanical dyssynchrony.
- Conventional methods may not fully capture the complexities of LV dyssynchrony, especially in patients with varying QRS durations.
Purpose of the Study:
- To evaluate the clinical applicability of a new Doppler tissue imaging (DTI) method for displaying LV function and dyssynchrony.
- To assess the utility of this novel method in patients with DCM and wide or narrow QRS complexes.
Main Methods:
- A hexagonal graph representation was created using time to peak velocities (TPVs) from 6 basal LV segments.
- Key metrics derived included percentage hexagon area (global LV systolic function), net-delay magnitude (mechanical dyssynchrony), and delayed contraction site.
Main Results:
- The novel method demonstrated correlations with established measures like pre-ejection period and LV ejection fraction.
- Net-delay magnitude was significantly higher in patients with wide QRS complexes compared to narrow QRS and controls.
- LV mechanical dyssynchrony was detected in 68% of wide QRS and 39% of narrow QRS patients, comparable to conventional DTI indexes.
Conclusions:
- The new DTI-based hexagonal graph method enables rapid recognition of LV function and dyssynchrony.
- Further research is needed to determine if this method can predict the success of cardiac resynchronization therapy.
Background:
The present study was conducted to assess the clinical applicability of a novel method of displaying left ventricular (LV) function and dyssynchrony using Doppler tissue imaging (DTI) in patients with dilated cardiomyopathy with wide or narrow QRS complexes.
Methods:
The study included 28 patients with wide QRS complexes, 36 with narrow QRS complexes, and 55 apparently healthy subjects (controls). The time to peak velocities (TPVs) obtained from 6 basal LV segments were assumed to be "vectors" and aligned radially such that each terminal point was directed to the corresponding LV segment. The resulting hexagonal graph covered the following aspects of LV function and dyssynchrony: (1) percentage area of the hexagon, the area divided by the overall graph area, reflecting global LV systolic function; (2) the net-delay magnitude of mechanical contraction, the length of the composite vector for the 6 vectors; and (3) delayed contraction site, the graphical position of the composite vector.
Results:
The percentage area of the hexagon was correlated with the pre-ejection period (r = 0.80; P < .001) and LV ejection fraction (r = -0.66; P < .001). The net-delay magnitude was longest in patients with wide QRS complexes and shortest in controls (123 +/- 61 vs 36 +/- 27 ms; P < .001). LV mechanical dyssynchrony on the basis of the new method (net-delay magnitude > 90 ms) was detectable in 68% of patients with wide QRS complexes and in 39% of those with narrow QRS complexes. The percentages were similar to those obtained using conventional DTI-derived indexes (the standard deviation and dispersion of TPVs in the 12 myocardial segments). The new method, moreover, revealed that patients with wide QRS complexes had delayed contraction sites located more often between the lateral and inferior wall segments than controls (68% vs 35%; P < .001).
Conclusions:
The new displaying method permits at-a-glance recognition of LV function and dyssynchrony. Whether the method can be used to predict resynchronization awaits further study.
