Measures of dyssynchrony in the left ventricle of healthy children and young patients with dilated cardiomyopathy

Vincent C. Thomas, Kristopher M. Cumbermack, Carey K. Lamphier, Christina R. Phillips, Derek A. Fyfe, Brandon K. Fornwalt

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Doppler tissue imaging may help identify children with dyssynchrony who could benefit from resynchronization therapy. However, few studies have quantified dyssynchrony measures in children; no study has investigated the relationship among age, heart rate, and dyssynchrony measures in children; and no study has quantified cross-correlation delay in children. The aim of this study was to test the hypotheses that measures of left ventricular dyssynchrony would correlate with age, primarily because of the correlation between heart rate and age, and that children with cardiomyopathy would have left ventricular dyssynchrony. Methods: Sixty healthy children and 11 children with dilated cardiomyopathy were prospectively enrolled. Seven dyssynchrony measures were quantified: septal-to-lateral delay, peak velocity difference, the standard deviations of times to peak in 12 segments in systole and diastole, and cross-correlation delay in systole, diastole, and the whole cycle. Results: The seven dyssynchrony measures were either not correlated with age or only weakly correlated with age after correcting for heart rate using Bazett's formula. Septal-to-lateral delay, peak velocity difference, and the standard deviation of times to peak in 12 segments in systole showed dyssynchrony in 57% to 85% of normal controls, compared with 20% for cross-correlation delay in the whole cycle and 3% for the standard deviation of times to peak in 12 segments in diastole. Cross-correlation delay in systole, cross-correlation delay in diastole, cross-correlation delay in the whole cycle, and the standard deviation of times to peak in 12 segments in diastole were elevated in children with dilated cardiomyopathy compared with controls. Conclusions: Echocardiographic dyssynchrony measures should be corrected for heart rate using Bazett's formula in children. Time-to-peak Doppler tissue imaging dyssynchrony measures classify many healthy children as having abnormalities with the timing of left ventricular contraction, which suggests that the methodology is not accurate in children. In preliminary studies, cross-correlation dyssynchrony measures show elevated systolic and diastolic measures of dyssynchrony in children with dilated cardiomyopathy compared with controls, which deserves further investigation to help identify children who may benefit from resynchronization therapy.

Original languageEnglish (US)
Pages (from-to)142-153
Number of pages12
JournalJournal of the American Society of Echocardiography
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2013

Fingerprint

Dilated Cardiomyopathy
Heart Ventricles
Diastole
Systole
Heart Rate
Cardiomyopathies

Keywords

  • Cardiomyopathy
  • Doppler tissue imaging
  • Dyssynchrony
  • Echocardiography
  • Pediatrics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Measures of dyssynchrony in the left ventricle of healthy children and young patients with dilated cardiomyopathy. / Thomas, Vincent C.; Cumbermack, Kristopher M.; Lamphier, Carey K.; Phillips, Christina R.; Fyfe, Derek A.; Fornwalt, Brandon K.

In: Journal of the American Society of Echocardiography, Vol. 26, No. 2, 01.02.2013, p. 142-153.

Research output: Contribution to journalArticle

Thomas, Vincent C. ; Cumbermack, Kristopher M. ; Lamphier, Carey K. ; Phillips, Christina R. ; Fyfe, Derek A. ; Fornwalt, Brandon K. / Measures of dyssynchrony in the left ventricle of healthy children and young patients with dilated cardiomyopathy. In: Journal of the American Society of Echocardiography. 2013 ; Vol. 26, No. 2. pp. 142-153.
@article{92eeb0c696854866af9573c2b1bf969c,
title = "Measures of dyssynchrony in the left ventricle of healthy children and young patients with dilated cardiomyopathy",
abstract = "Background: Doppler tissue imaging may help identify children with dyssynchrony who could benefit from resynchronization therapy. However, few studies have quantified dyssynchrony measures in children; no study has investigated the relationship among age, heart rate, and dyssynchrony measures in children; and no study has quantified cross-correlation delay in children. The aim of this study was to test the hypotheses that measures of left ventricular dyssynchrony would correlate with age, primarily because of the correlation between heart rate and age, and that children with cardiomyopathy would have left ventricular dyssynchrony. Methods: Sixty healthy children and 11 children with dilated cardiomyopathy were prospectively enrolled. Seven dyssynchrony measures were quantified: septal-to-lateral delay, peak velocity difference, the standard deviations of times to peak in 12 segments in systole and diastole, and cross-correlation delay in systole, diastole, and the whole cycle. Results: The seven dyssynchrony measures were either not correlated with age or only weakly correlated with age after correcting for heart rate using Bazett's formula. Septal-to-lateral delay, peak velocity difference, and the standard deviation of times to peak in 12 segments in systole showed dyssynchrony in 57{\%} to 85{\%} of normal controls, compared with 20{\%} for cross-correlation delay in the whole cycle and 3{\%} for the standard deviation of times to peak in 12 segments in diastole. Cross-correlation delay in systole, cross-correlation delay in diastole, cross-correlation delay in the whole cycle, and the standard deviation of times to peak in 12 segments in diastole were elevated in children with dilated cardiomyopathy compared with controls. Conclusions: Echocardiographic dyssynchrony measures should be corrected for heart rate using Bazett's formula in children. Time-to-peak Doppler tissue imaging dyssynchrony measures classify many healthy children as having abnormalities with the timing of left ventricular contraction, which suggests that the methodology is not accurate in children. In preliminary studies, cross-correlation dyssynchrony measures show elevated systolic and diastolic measures of dyssynchrony in children with dilated cardiomyopathy compared with controls, which deserves further investigation to help identify children who may benefit from resynchronization therapy.",
keywords = "Cardiomyopathy, Doppler tissue imaging, Dyssynchrony, Echocardiography, Pediatrics",
author = "Thomas, {Vincent C.} and Cumbermack, {Kristopher M.} and Lamphier, {Carey K.} and Phillips, {Christina R.} and Fyfe, {Derek A.} and Fornwalt, {Brandon K.}",
year = "2013",
month = "2",
day = "1",
doi = "10.1016/j.echo.2012.10.014",
language = "English (US)",
volume = "26",
pages = "142--153",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Measures of dyssynchrony in the left ventricle of healthy children and young patients with dilated cardiomyopathy

AU - Thomas, Vincent C.

AU - Cumbermack, Kristopher M.

AU - Lamphier, Carey K.

AU - Phillips, Christina R.

AU - Fyfe, Derek A.

AU - Fornwalt, Brandon K.

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Background: Doppler tissue imaging may help identify children with dyssynchrony who could benefit from resynchronization therapy. However, few studies have quantified dyssynchrony measures in children; no study has investigated the relationship among age, heart rate, and dyssynchrony measures in children; and no study has quantified cross-correlation delay in children. The aim of this study was to test the hypotheses that measures of left ventricular dyssynchrony would correlate with age, primarily because of the correlation between heart rate and age, and that children with cardiomyopathy would have left ventricular dyssynchrony. Methods: Sixty healthy children and 11 children with dilated cardiomyopathy were prospectively enrolled. Seven dyssynchrony measures were quantified: septal-to-lateral delay, peak velocity difference, the standard deviations of times to peak in 12 segments in systole and diastole, and cross-correlation delay in systole, diastole, and the whole cycle. Results: The seven dyssynchrony measures were either not correlated with age or only weakly correlated with age after correcting for heart rate using Bazett's formula. Septal-to-lateral delay, peak velocity difference, and the standard deviation of times to peak in 12 segments in systole showed dyssynchrony in 57% to 85% of normal controls, compared with 20% for cross-correlation delay in the whole cycle and 3% for the standard deviation of times to peak in 12 segments in diastole. Cross-correlation delay in systole, cross-correlation delay in diastole, cross-correlation delay in the whole cycle, and the standard deviation of times to peak in 12 segments in diastole were elevated in children with dilated cardiomyopathy compared with controls. Conclusions: Echocardiographic dyssynchrony measures should be corrected for heart rate using Bazett's formula in children. Time-to-peak Doppler tissue imaging dyssynchrony measures classify many healthy children as having abnormalities with the timing of left ventricular contraction, which suggests that the methodology is not accurate in children. In preliminary studies, cross-correlation dyssynchrony measures show elevated systolic and diastolic measures of dyssynchrony in children with dilated cardiomyopathy compared with controls, which deserves further investigation to help identify children who may benefit from resynchronization therapy.

AB - Background: Doppler tissue imaging may help identify children with dyssynchrony who could benefit from resynchronization therapy. However, few studies have quantified dyssynchrony measures in children; no study has investigated the relationship among age, heart rate, and dyssynchrony measures in children; and no study has quantified cross-correlation delay in children. The aim of this study was to test the hypotheses that measures of left ventricular dyssynchrony would correlate with age, primarily because of the correlation between heart rate and age, and that children with cardiomyopathy would have left ventricular dyssynchrony. Methods: Sixty healthy children and 11 children with dilated cardiomyopathy were prospectively enrolled. Seven dyssynchrony measures were quantified: septal-to-lateral delay, peak velocity difference, the standard deviations of times to peak in 12 segments in systole and diastole, and cross-correlation delay in systole, diastole, and the whole cycle. Results: The seven dyssynchrony measures were either not correlated with age or only weakly correlated with age after correcting for heart rate using Bazett's formula. Septal-to-lateral delay, peak velocity difference, and the standard deviation of times to peak in 12 segments in systole showed dyssynchrony in 57% to 85% of normal controls, compared with 20% for cross-correlation delay in the whole cycle and 3% for the standard deviation of times to peak in 12 segments in diastole. Cross-correlation delay in systole, cross-correlation delay in diastole, cross-correlation delay in the whole cycle, and the standard deviation of times to peak in 12 segments in diastole were elevated in children with dilated cardiomyopathy compared with controls. Conclusions: Echocardiographic dyssynchrony measures should be corrected for heart rate using Bazett's formula in children. Time-to-peak Doppler tissue imaging dyssynchrony measures classify many healthy children as having abnormalities with the timing of left ventricular contraction, which suggests that the methodology is not accurate in children. In preliminary studies, cross-correlation dyssynchrony measures show elevated systolic and diastolic measures of dyssynchrony in children with dilated cardiomyopathy compared with controls, which deserves further investigation to help identify children who may benefit from resynchronization therapy.

KW - Cardiomyopathy

KW - Doppler tissue imaging

KW - Dyssynchrony

KW - Echocardiography

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=84872913404&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872913404&partnerID=8YFLogxK

U2 - 10.1016/j.echo.2012.10.014

DO - 10.1016/j.echo.2012.10.014

M3 - Article

C2 - 23200242

AN - SCOPUS:84872913404

VL - 26

SP - 142

EP - 153

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 2

ER -