Feasibility of a New Tissue Doppler Based Method for Comprehensive Evaluation of Left-Ventricular Intra-Ventricular Mechanical Dyssynchrony in Children With Dilated Cardiomyopathy

Abstract

The feasibility of a new comprehensive method to detect mechanical dyssynchrony in pediatric dilated cardiomyopathy (DCM) was assessed. Doppler tissue imaging was performed in 12 left ventricular (LV) segments in 24 children with DCM and 19 controls. Receiver operating characteristic analysis was used to evaluate sensitivity and specificity characteristics of the new mechanical dyssynchrony score using the established dyssynchrony index as a reference. Correlations with ventricular function were investigated. The new dyssynchrony score showed greater systolic mechanical dyssynchrony in patients with DCM compared with controls (302 +/- 150 vs 95 +/- 72 ms; P < .0001). Diastolic dyssynchrony measured by the new method was similar between groups (282 +/- 179 vs 226 +/- 88 ms; P = .2). Using the established dyssynchrony index as a reference, the dyssynchrony score had an area under the receiver operating characteristic curve of 0.887 for systole and 0.817 for diastole. The new method had sufficient intraobserver and interobserver reliability. A new comprehensive method is feasible, reliable, and adequately sensitive and specific to detect mechanical dyssynchrony in pediatric DCM.