Spatial distribution of intraventricular dyssynchrony in relation to infarct location: a cardiovascular magnetic resonance tissue synchronization mapping study

Paul William Foley, Kayvan Khadjooi, Shajil Chall, Berthed Stegemann, Simona P. Ungureanu, Russell Ea Smith, Michael Frenneaux, Francisco Leyva

Research output: Contribution to journalAbstract

Abstract

Background: In echocardiographic studies, dyssynchrony is often equated with nonviability and it is thought that dyssynchrony is greatest over the infarct site. We have used magnetic resonance tissue synchronization mapping (CMR-TSM) to explore the spatial distribution of dyssynchrony in patients with myocardial infarctions affecting the anteroseptal and posterolateral left ventricular (LV) territories.

Methods: 56 patients (age 66.9 ± 10.1 yrs, LVEF 25.5 ± 12.3%) and 23 age-matched healthy controls underwent CMR-TSM, which provided the global tissue synchronization index (CMR-TSIglobal), the standard deviation of the time-to-peak inward wall motion for each of 6 segments per LV short-axis slice, in up to 10 slices from LV base to apex (up to 60 segments); a regional measure, expressed as the CMR-TSI for segments in either the infarct zone (CMR-TSI scar) or remote from the infarct zone (CMR-TSI remote).

Results: CMR-TSIglobal was higher in patients with anteroseptal (104 ± 39 ms, p<0.0001) and posterolateral infarcts (126 ± 70, p<0.0001) than in controls (42 ± 12 ms). There was no differences in CMR-TSI scar and CMR-TSI remote between the anteroseptal or posterolateral territories (see Table).

Conclusions: In patients with ischemic cardiomyopathy, radial dyssynchrony is as
marked in the infarct zone as in remote myocardium. These findings imply that localised mechanical dyssynchrony does not equate with non-viability.
Original languageEnglish
Pages (from-to)A158
Number of pages1
JournalJournal of the American College of Cardiology
Volume51
Issue number10, Supplement 1
DOIs
Publication statusPublished - 11 Mar 2008

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