Assessment of regional timing of left ventricular systolic longitudinal movement by Doppler tissue synchronization imaging in structurally normal hearts

Aims

To study the feasibility of a new semiautomatic echocardiographic modality called Tissue Synchronization Imaging (TSI) for measurement of the longitudinal left ventricular (LV) movement.

Methods and results

TSI was used in 20 subjects with structurally normal hearts to measure the time aspect of the regional longitudinal LV systolic movement in the apical four chamber view. Inter- and intraobserver agreement and the beat to beat variation were tested and compared to previously manually measured peak systolic delay (PSD) between the interventricular septum (IS) and the lateral free wall (LFW) at basal and mid LV, respectively ( n = 19). TSI showed acceptable reproducibility and close correlation to manually measured PSD. The TSI method did not show false synchronous regional LV movement when synchrony was defined as a PSD <±25 ms. After minor adjustment of the TSI interval, 76.9% of the synchronous LV patterns in basal LV were correctly classified as compared to manual measurements.

Conclusions

The TSI method is accurate for clinical screening to reveal synchrony. At the present development the TSI method is not accurate enough to quantify regional systolic LV asynchrony, and still manual measurement of PSD is mandatory.