Quantitative analysis of left ventricular dyssynchrony using cardiac computed tomography versus three-dimensional

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Updated: May 25, 2026

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

Sebastian J Buss1, Felix Schulz, David Wolf

  • 1Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.

European Radiology
|January 25, 2012
PubMed

Insights

Cardiac computed tomography (CCT) offers a faster and more reproducible method for assessing left ventricular (LV) dyssynchrony compared to real-time three-dimensional echocardiography (RT3DE). This makes CCT a promising alternative for patients considered for cardiac resynchronisation therapy (CRT).

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Techniques

Background:

  • Assessing left ventricular (LV) dyssynchrony is crucial for patients considered for cardiac resynchronisation therapy (CRT).
  • Real-time three-dimensional echocardiography (RT3DE) is a current method for this assessment.
  • Limitations of RT3DE include analysis time and reproducibility.

Purpose of the Study:

  • To investigate the feasibility of cardiac computed tomography (CCT) in determining intraventricular dyssynchrony.
  • To compare CCT with RT3DE for dyssynchrony assessment in CRT candidates.
  • To evaluate the reproducibility and analysis time of CCT versus RT3DE.

Main Methods:

  • 35 patients considered for CRT underwent both RT3DE and ECG-gated contrast-enhanced 64-slice dual-source CCT.
  • Left ventricular (LV) dyssynchrony was quantified using the standard deviation index (SDI) with the 4D LV-Analysis software for both techniques.
  • Comparison focused on correlation of SDI, end-systolic volume, end-diastolic volume, and LV ejection fraction.

Main Results:

  • High correlations were found between CCT and RT3DE for volumetric parameters (r=0.92-0.95) and global dyssynchrony index SDI (r=0.84).
  • Correlation for SDI improved to r=0.90 after excluding segments with poor echocardiographic image quality.
  • CCT analysis time was significantly shorter (162s vs. 608s) and reproducibility was significantly higher (4.5% vs. 7.9% interobserver variability) compared to RT3DE.

Conclusions:

  • Quantitative assessment of LV dyssynchrony is feasible using CCT.
  • CCT demonstrates higher reproducibility and significantly faster analysis times than RT3DE.
  • CCT presents a valuable alternative for dyssynchrony assessment in patients considered for CRT.
Abstract

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