Abstract 2815: Validation of Rapid Automated Tissue Synchronisation Imaging Techniques for Assessment of Cardiac Dyssynchrony in both Sinus and Non-Sinus Rhythm
Background: Intraventricular dyssynchrony predicts left ventricle remodelling and clinical response following cardiac resynchronisation therapy. Currently, no consensus exists as to the most appropriate methodology for assessing dyssynchrony. Tissue Velocity Imaging (TVI) based septal to lateral delay (SLD) >65ms (Bax et al) and 12 segment dyssynchrony index (DI) (Yu et al) are most commonly used. These methods are time consuming and involve multiple manual calculations. Automated dyssynchrony assessment with Tissue Synchronisation Imaging (TSI) may provide a more rapid estimation of dyssynchrony.
Aims: To assess the validity of automated TSI (TSI auto) based dyssynchrony measures in comparison to established TVI techniques.
Methods: We randomly selected echocardiograms of 51 subjects (Sinus rhythm (SR) n=35, AF/paced n=16) from our heart failure service and compared TSI auto to conventional TVI methods (SLD and DI). For TSI auto, 6 basal and 6 mid segments were defined and dyssynchrony parameters calculated with the Echopac 6 software.
Results: The mean age of the group was 66±11 years, 86% were male. The majority had ischaemic aetiology (69%) and the mean LVEF was 35.2±1.3%. Mean QRS duration was 138±6ms (LBBB 54%) and 69% were in SR. Bland-Altman analysis of TVI and TSI auto DI showed excellent agreement (Limits of agreement (LOA): -8.7 to 15.9, p=0.16) (Figure⇓). Agreement between SLD techniques was acceptable (LOA: -169 to 137 p=0.9). ROC curves were constructed for TSI auto (AUC SR 0.9, non-SR 0.917).
Conclusions: Automated TSI provides an accurate and efficient means of measurement of intraventricular dyssynchrony in both sinus and non sinus rhythm.