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Calibration of the Normal Cutoff Values of Systolic Dyssynchrony of the Left Ventricular Synchronicity in Normal Subjects Using Real-Time 3-Dimensional Echocardiography and the Effects of Age and Heart Rate

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Abstract

The normal data of left ventricular (LV) synchronicity by real-time 3-dimensional echocardiography (RT3DE) are lacking. We assessed the normal range/cutoff values of LV dyssynchrony parameters by RT3DE. For this purpose, RT3DE was performed in 130 healthy subjects, aged 53 ± 12 years. Time to the point of minimal regional systolic volume (Tmsv) was measured from time–volume curves in each segment. Standard deviation (SD) and maximal difference (Dif) of Tmsv were calculated from 16 (6 basal/6 mid/4 apical), 12 (6 basal/6 mid), and 6 (basal) LV segments together with the corresponding parameters adjusted by R–R interval. The data show non-significant difference between Tmsv-16-SD (9.24 ± 3.54 ms) and Tmsv-12-SD (8.80 ± 3.82 ms); with a correlation between two by both unadjusted (ms; r = 0.87) and adjusted (%R–R; r = 0.84) methods (P < 0.001). Heart rate correlated negatively with Tmsv (r = −0.13 to −0.34, P < 0.05–0.001) but had no effect on parameters adjusted for %R–R. Age and gender did not affect any of these parameters. Inter-observer variability was 3.3–4.6 % for 16, 4.8–9.1 % for 12, and 14.4–19.7 % for 6 segments. Thus, RT3DE is a reliable technique for detecting LV systolic dyssynchrony whereas the heart rate, but not age and gender, affects Tmsv parameters. Dyssynchrony parameters by 16 or 12 segments are superior to 6 segments in yielding comprehensive information and lower variability.

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Acknowledgments

We are grateful to Professor Cheuk-Man Yu for his help with the manuscript editing.

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Authors and Affiliations

  1. Department of Cardiovascular Function, First Hospital, China Medical University, Shenyang, 110001, China

    Chun-Yan Ma, Shuang Liu, Jun Yang & Li Tang

  2. Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Institute of Vascular Medicine, S.H. Ho Cardiovascular and Stroke Centre, Shatin, Hong Kong

    Qing Zhang, Gabriel Yip & Cheuk-Man Yu

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  1. Chun-Yan Ma
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  2. Shuang Liu
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  3. Qing Zhang
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  4. Jun Yang
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  5. Li Tang
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  7. Cheuk-Man Yu
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Correspondence to Chun-Yan Ma.

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Ma, CY., Liu, S., Zhang, Q. et al. Calibration of the Normal Cutoff Values of Systolic Dyssynchrony of the Left Ventricular Synchronicity in Normal Subjects Using Real-Time 3-Dimensional Echocardiography and the Effects of Age and Heart Rate. Cell Biochem Biophys 69, 115–121 (2014). https://doi.org/10.1007/s12013-013-9777-3

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