Assessment of asynchrony with: | Ref. | Criteria | Segments | Limitations | Analysis time | Prediction of benefit |
---|---|---|---|---|---|---|
I. Global ventricular asynchrony | ||||||
ECG | 4, 44 | QRS width >120 ms | Global assessment | LBBB after myocardial infarction | Short | Low (30% non-responder) |
M-mode | 21 | Septal-to-posterior wall motion delay >130 ms | septal and posterior | scar tissue, only septal or posterior | Short | low |
pw-TDI | 25 | Cumulative asynchrony (EMD) >102 ms | Intra LV (5 basal segments) and interventricular (vs. RV lateral segment) | Low spatial resolution | Long | Good prediction of acute response (AUC in ROC 0,84) |
II. Interventricular asynchrony | ||||||
pw-Doppler echocardiography | 47 | Interventricular mechanical delay (IVMD) >40 ms | Aortic and pulmonary outflow tract | Not simultaneous | Short | No |
III. Intraventricular asynchrony | ||||||
2D-TDI | 27 | Ts-SD: intraventricular systolic asynchrony index: >33 ms | 12 segments | complex (post-processing) | Long | Acute response (3 months) |
4, 32 | Difference in septal-lateral time-to-peak TDI, cut-off >60 ms | 12 segments | Complex | Long | EF increase after BVP | |
40 | Mean regional myocardial performance index: Difference between regional Q-wave-to.peak systolic displacement times | 12 segments 4 segments | Complex | Long, offline | Acute response | |
33 | Ts-SD: cut-off: 31,4 ms | 12 segments | Complex | Long | 3 months response, reverse remodeling | |
Strain and strain rate | 15, 34, 33 | Myocardial deformation in systole, presence of post-systolic shortening | 12 segments | Complex, time consuming, in dilated ventricles low spatial resolution) | Long | Controversial data |
Tissue Tracking | 28 | DLC in >2 basal segments | 12 basal segments in apical four chamber view. | Requires correct timing of LV events | Short | Acute response |
TSI | 36 | Color-coded time-to-peak tissue Doppler velocities (cut-off >65 ms in anteroseptum and posterior wall in apical long axis view) | 16 segments except apex | Only velocity data | Short | Acute response (Sensitivity 87% Specificity 100%) |
3-D-echo | 26 | No quantitative criteria defined | All segments | Reduced spatial resolution | Time consuming, off-line analysis | No systematic data |
Automated endocardial border detection (ABD) | 26 | Septal-lateral phase angle difference | 100 segments. apical-four-chamber view (septal-lateral) | High complexity, single imaging plane | Long, only off-line | Acute response |
ABD + Contrast | 46 | Echo-contrast cardiac variability imaging: displacement maps | apical four chamber | High complexity, single imaging plane | Long | Acute response |