Objective: To quantify ventricular resynchronisation by biventricular pacing using colour tissue Doppler velocity imaging (c-TVI).
Design and patients: c-TVI shows regional tissue velocity profiles with a very high time resolution (10 ms). Eighteen patients were studied from an apical four chamber view at baseline and after a one month follow up of biventricular pacing. Regional left ventricular peak tissue velocities and regional time differences during the cardiac cycle were compared in the basal and mid interventricular septal segments of the left ventricle, and in the corresponding segments in the left ventricular free wall.
Results: From baseline to follow up, mean peak tissue velocities changed only during isovolumic contraction in the basal interventricular septum and the left ventricular free wall. At baseline the peak main systolic tissue velocities in the left ventricular free wall were typically delayed by an average of 42 ms in the basal left ventricular site and by 14 ms in the mid left ventricular site compared with the corresponding sites in the interventricular septum. After resynchronisation by biventricular pacing those regional movements were separated by an average of only 7 ms at the basal site, but there was still a 21 ms earlier movement of the left ventricular free wall in the mid left ventricular site. The diastolic movement pattern remained unchanged from baseline to follow up.
Conclusions: c-TVI showed a significant asynchronous regional longitudinal movement of basal left ventricular sites at baseline. A change to a more synchronous longitudinal left ventricular movement pattern during biventricular pacing was demonstrated.
- colour tissue velocity imaging
- biventricular pacing
- heart failure
- A, late diastolic peak velocity
- c-TVI, colour tissue velocity imaging
- E, early diastolic peak velocity
- fps, frames per second
- IVC, isovolumic contraction
- MRI, magnetic resonance imaging
- SYS, peak main systolic velocity
- 6MHWT, six minute hall walk test
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