Assessment Of Left Ventricular Systolic Synchronicity In Patients With Heart Failure By Real-time Three-dimensional Echocardiography

Left ventricular (LV) mechanical dyssynchrony is a relatively common problem in chronic heart failure patients. Cardiac resynchronization therapy (CRT) is a novel and promising therapy for patients with chronic heart failure, which reproduce the synchronization of electric activation and mechanical motion by the implantation of the pacing lead. The tissue Doppler imaging technology used to evaluate the LV dyssynchrony could not assess the LV global dyssynchrony simultaneously, which is conquered by the real-time three-dimensional echocardiography (RT3DE). The objective of this study is to investigate the feasibility and the value of real-time three-dimensional echocardiography (RT3DE) in the quantification of the left ventricular systolic synchronicity in patients with heart failure. This thesis is composed of two parts as follow:Part1. Assessment of left ventricular systolic synchronicity by real-time three-dimensional echocardiography in patients with different degree heart failureThe objective of this part is to investigate the feasibility and the value of real-time three-dimensional echocardiography (RT3D) in the quantification of the left ventricular systolic synchronicity in patients with different degree chronic heart failure (CHF). RESULTS: All the targets of the CHF group about systolic asynchrony derived from RT3DE were obviously higher than those of the healthy group (P<0.05). In the CHF group the asynchrony indexes of subgroup B were significantly higher than those of subgroup A(P<0.05). The asynchrony indexes gained from RT3DE correlated well with Ts-SD((r=0.612~0.825,P<0.05). The LV 17 segmental time-volume curve reflects the LV global mechanical systolic dyssynchrony directly.Part2. Assessment of left ventricular systolic synchronicity by real-time three-dimensional echocardiography in chronic heart failure patients with different QRS durationThe purpose of this part is to explore the feasibility and the value of real-time three-dimensional echocardiography (RT3D) in the quantification of the left ventricular systolic synchronicity in chronic heart failure (CHF) patients with the different QRS duration. RESULTS: All the targets of the CHF group about systolic asynchrony derived from RT3DE were obviously higher than those of the healthy group independently of the QRS duration (P<0.05). There was no significant difference of the dyssynchrony indexes between subgroup A (QRS duration>120ms) and B (QRS duration≤120ms). Parametric imaging report could display the latest contractive segment directly.Conclusion:①It is feasible that using real-time three-dimensional echocardiography to quantify the left ventricular dyssynchrony for chronic heart failure patients.②As the left ventricular function deteriorates, the LV mechanical dyssynchrony increases.③There is no necessary correlation between the prolonged QRS duration and the LV systolic dyssynchrony.④RT3D can display the LV mechanical dyssynchrony and the latest contractive segment directly.