Assessment of left ventricular (LV) dyssynchrony after myocardial infarction has prognostic
value. There were no reference ranges for 2-dimensional (2D) speckle tracking synchrony,
and it was unclear whether color tissue Doppler imaging and 2D speckle tracking synchrony
indexes were comparable. One hundred twenty-two healthy volunteers and 40 patients
with non–ST-elevation myocardial infarction (NSTEMI) had LV systolic and diastolic
synchrony, defined as the SD of time to peak systolic (2D-SDTs) and early diastolic
(2D-SDTe) velocities in the 12 basal and mid segments using 2D speckle tracking, respectively.
Mean 2D-SDTs and 2D-SDTe were 29.4 ± 16.1 and 14.2 ± 6.1 ms in healthy subjects, respectively.
Gender and mean 2D systolic velocity independently predicted 2D-SDTs, and mean 2D
early diastolic velocity independently predicted 2D-SDTe. Bland-Altman analysis showed
suboptimal agreement between 2D speckle tracking and tissue Doppler imaging dyssynchrony
indexes. 2D speckle tracking showed lower coefficients of variation for time to peak
systolic and early diastolic velocities than tissue Doppler imaging. There were no
significant differences in coefficients of variation for 2D speckle tracking systolic
and diastolic synchrony for high versus low frame rates. Patients with NSTEMI had
significantly lower ejection fraction, but higher LV mass and wall stress than healthy
subjects. Only 2D-SDTs was significantly higher in patients with NSTEMI compared with
healthy subjects (37.1 ± 22.5 vs 29.4 ± 16.1 ms; p = 0.02). In conclusion, 2D-SDTs
was gender specific and influenced by global systolic function, and 2D-SDTe was influenced
by global diastolic function. 2D speckle tracking and tissue Doppler imaging dyssynchrony
indexes were not comparable. 2D speckle tracking may be a more sensitive discriminator
of LV systolic dyssynchrony than tissue Doppler imaging.
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Article info
Publication history
Published online: August 19, 2008
Accepted:
June 30,
2008
Received in revised form:
June 30,
2008
Received:
June 7,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
