Abstract：Objective: To Discuss the clinical value of real-time three-dimensional echocardiography for studying LV systolic synchrony in patients with left heart insufficiency. Methods: Normal control group consisted of 31 normal subjects, and left heart insufficiency group included 96 patients. Patients in left heart insufficiency group were divided into three subgroups according to LVEF and two subgroups on the basis of QRS width. The former consisted of mild(30), moderate(34) and severe(32) left heart insufficiency patients, and the latter included narrow QRS duration group(32) and wide QRS duration group(64). Real-time three-dimensional echocardiography volume-time curves of all subjects were analyzed, the cut-off value used to define LV systolic dys-synchrony was defined arbitrarily as the mean+3SD of the Tmsv16-SD% value found in normal control group. Results: SDI increased with worsening of LV systolic function(mild, 2.71%±4.52%; moderate, 5.56%±2.22%; severe left heart insufficiency, 7.88%±1.67%; P for trend <0.01); The SDI was higher in patients with mild left heart insufficiency, compared with 1.54%±0.85% in normal subjects(P<0.05); The SDI was significantly higher in patients with moderate, severe left heart insufficiency, compared with normal subjects(P<0.01). Left ventricular systolic dys-synchrony was observed in 6.67%(2,30), 38.24%(13,34), 68.75%(22,32) in patients with mild, moderate, severe left heart insufficiency respectively. There were significant difference between the moderate, severe and mild left heart insufficiency group(P＜0.01); there were difference between the moderate and severe left heart insufficiency group(P＜0.05). Left ventricular systolic dys-synchrony was observed in 56.25%(18,32), 79.06%(50,64) patients with narrow and wide QRS duration group, there were difference between them(P＜0.05). Significantly negative correlation was presented in patients with left heart insufficiency group between LVEF and SDI(r=-0.752, P＜0.001), weak correlation was found between SDI and QRS duration(r=0.256, P=0.011). Conclusion: RT-3DE can be used to assess the left ventricular systolic synchrony and represent a novel technique to identify left heart insufficiency who may otherwise not be considered for CRT.
2010, Vol. 21 
