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J Am Soc Echocardiogr. 2007 Dec;20(12):1330-1337.e1. Epub 2007 Jul 23.

Cross-correlation quantification of dyssynchrony: a new method for quantifying the synchrony of contraction and relaxation in the heart.

Author information

1
Emory University School of Medicine, Atlanta, Georgia 30322, USA. bfornwa@emory.edu

Abstract

BACKGROUND:

Quantification of left ventricular dyssynchrony using Doppler tissue imaging may improve selection of patients who will benefit from cardiac resynchronization therapy. Most methods used to quantify dyssynchrony use a time-to-peak analysis, which is quantitatively simplistic and requires manual identification of systole and selection of peak velocities.

METHODS:

We developed and tested a new, highly automatable dyssynchrony parameter, cross-correlation delay (XCD), that does not require identification of systole or manual selection of peak systolic velocities. XCD uses all velocity data points from 3 consecutive beats (approximately 420 points). We tested XCD on 11 members of a positive control group (responders to cardiac resynchronization therapy with a >or=15% reduction in left ventricular end-systolic volume) and 12 members of a negative control group (normal 12-lead electrocardiogram and 2-dimensional echocardiogram findings). We compared XCD to septal-to-lateral delay in time-to-peak (SLD), maximum difference in the basal 2- or 4-chamber times to peak (MaxDiff), and SD of the 12 basal and midwall times-to-peak (Ts-SD).

RESULTS:

XCD and Ts-SD were significantly different between the positive and negative control groups (both P <or= .0001). SLD and MaxDiff demonstrated no difference between the positive and negative control groups. XCD and Ts-SD were superior to SLD and MaxDiff in discriminating between positive and negative control groups (both P < .01 by receiver operating characteristic comparison). XCD, SLD, MaxDiff, and Ts-SD demonstrated dyssynchrony in 0%, 50%, 58%, and 50% of the negative control group, respectively. XCD was the only parameter that decreased after resynchronization in the positive control group (from 160 +/- 88-69 +/- 61 milliseconds, P = .003).

CONCLUSION:

XCD is superior to existing parameters at discriminating patients with left ventricular dyssynchrony from those with normal function.

PMID:
17643956
DOI:
10.1016/j.echo.2007.04.030
[Indexed for MEDLINE]

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