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Quantitation of left-ventricular asynergy by cardiac ultrasound

Sutherland, George R. ; Kukulski, Tomasz ; Kvitting, Jon Escobar ; D'Hooge, Jan ; Arnold, Martina ; Brandt, Einar LU ; Hatle, Liv and Wranne, Bengt (2000) In American Journal of Cardiology 86(4 SUPPL. 1). p.4-9
Abstract

The clinical evaluation of regional delays in myocardial motion (myocardial asynchrony) has proved problematic, yet it remains an important functional parameter to evaluate. Prior attempts to quantify regional asynergy have met with limited success, often thwarted by the low temporal resolution of imaging-system data acquisition. If a delay in onset of motion of 30-40 msec is clinically important to measure, then data acquisition at frame rates of 50-100 per second is required. This is out of the current temporal resolution of angiographic, nuclear, or magnetic resonance studies. Only cardiac ultrasound can currently achieve the necessary frame rates. Furthermore, quantitative studies into the accuracy with which a trained observer can... (More)

The clinical evaluation of regional delays in myocardial motion (myocardial asynchrony) has proved problematic, yet it remains an important functional parameter to evaluate. Prior attempts to quantify regional asynergy have met with limited success, often thwarted by the low temporal resolution of imaging-system data acquisition. If a delay in onset of motion of 30-40 msec is clinically important to measure, then data acquisition at frame rates of 50-100 per second is required. This is out of the current temporal resolution of angiographic, nuclear, or magnetic resonance studies. Only cardiac ultrasound can currently achieve the necessary frame rates. Furthermore, quantitative studies into the accuracy with which a trained observer can identify computed regional myocardial asynchrony in a left- ventricular 2-dimensional (2-D) image have shown that regional delays of < 80 msec are not normally recognized in a moving image. This may be improved to 60 msec when either training is undertaken or comparative image review is used. However, this is still out of the temporal resolution required in clinical practice. Thus, visual interpretation of asynchrony is not sufficiently accurate. Two ultrasound data sets based on either integrated backscatter or Doppler myocardial imaging data may provide the solution. Doppler myocardial imaging is a new ultrasound technique which, in either its pulsed or color Doppler format, can achieve the required temporal resolution (with temporal resolutions of 8 msec and 16 msec, respectively). In contrast, color Doppler myocardial imaging, in its curved M-mode format, can display the timing of events during the cardiac cycle for all in-plane myocardial segments. This should allow the quantitation of regional delay for all systolic and diastolic events. Potentially, asynchrony due to regional ischemia, bundle branch block, ventricular premature beats, and ventricular preexcitation could all be identified and the degree of delay quantified. This overview will aim to establish the potential role of these new ultrasound methodologies in the recognition and quantitation of left- ventricular asynergy and how they might best be introduced into clinical practice. (C) 2000 by Excerpta Medica, Inc.

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author
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publishing date
type
Contribution to journal
publication status
published
in
American Journal of Cardiology
volume
86
issue
4 SUPPL. 1
pages
4 - 9
publisher
Excerpta Medica
external identifiers
  • scopus:0034680074
  • pmid:10997344
ISSN
0002-9149
DOI
10.1016/S0002-9149(00)00982-6
language
English
LU publication?
no
id
6b69d560-a236-49f6-9588-819385c59d5b
date added to LUP
2022-10-21 10:25:00
date last changed
2024-05-02 16:18:48
@article{6b69d560-a236-49f6-9588-819385c59d5b,
  abstract     = {{<p>The clinical evaluation of regional delays in myocardial motion (myocardial asynchrony) has proved problematic, yet it remains an important functional parameter to evaluate. Prior attempts to quantify regional asynergy have met with limited success, often thwarted by the low temporal resolution of imaging-system data acquisition. If a delay in onset of motion of 30-40 msec is clinically important to measure, then data acquisition at frame rates of 50-100 per second is required. This is out of the current temporal resolution of angiographic, nuclear, or magnetic resonance studies. Only cardiac ultrasound can currently achieve the necessary frame rates. Furthermore, quantitative studies into the accuracy with which a trained observer can identify computed regional myocardial asynchrony in a left- ventricular 2-dimensional (2-D) image have shown that regional delays of &lt; 80 msec are not normally recognized in a moving image. This may be improved to 60 msec when either training is undertaken or comparative image review is used. However, this is still out of the temporal resolution required in clinical practice. Thus, visual interpretation of asynchrony is not sufficiently accurate. Two ultrasound data sets based on either integrated backscatter or Doppler myocardial imaging data may provide the solution. Doppler myocardial imaging is a new ultrasound technique which, in either its pulsed or color Doppler format, can achieve the required temporal resolution (with temporal resolutions of 8 msec and 16 msec, respectively). In contrast, color Doppler myocardial imaging, in its curved M-mode format, can display the timing of events during the cardiac cycle for all in-plane myocardial segments. This should allow the quantitation of regional delay for all systolic and diastolic events. Potentially, asynchrony due to regional ischemia, bundle branch block, ventricular premature beats, and ventricular preexcitation could all be identified and the degree of delay quantified. This overview will aim to establish the potential role of these new ultrasound methodologies in the recognition and quantitation of left- ventricular asynergy and how they might best be introduced into clinical practice. (C) 2000 by Excerpta Medica, Inc.</p>}},
  author       = {{Sutherland, George R. and Kukulski, Tomasz and Kvitting, Jon Escobar and D'Hooge, Jan and Arnold, Martina and Brandt, Einar and Hatle, Liv and Wranne, Bengt}},
  issn         = {{0002-9149}},
  language     = {{eng}},
  number       = {{4 SUPPL. 1}},
  pages        = {{4--9}},
  publisher    = {{Excerpta Medica}},
  series       = {{American Journal of Cardiology}},
  title        = {{Quantitation of left-ventricular asynergy by cardiac ultrasound}},
  url          = {{http://dx.doi.org/10.1016/S0002-9149(00)00982-6}},
  doi          = {{10.1016/S0002-9149(00)00982-6}},
  volume       = {{86}},
  year         = {{2000}},
}