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Echo Reliability for Spotting Dysynchrony

Echo measures of dyssynchrony are increasingly used to
select CHFers for CRT. Echo variables need to be
reproducible when done by different techs using different
echo equipment.
	We studied reproducibility and value of echo
measures for heart dysynchrony in 40 subjects sorted by
QRS interval and left heart pumping function.
	Two echos were done on each patient by different
echo techs on different machines and each study was checked
by 2 observers.
	All blood-pool and Tissue Doppler Imaging (TDI)
measures of dysynchrony were reliable in over 97% of patients'
echos. Blood-pool measures were the most reproducible 
measures of ventricular dysynchrony (aortic ejection delay)
*and* for dysynchrony between the 2 ventricles
(aortopulmonary difference in ejection delay).
	For annular tissue doppler delays, the time to peak
velocity was more reliable than time to velocity onset.
	So there are differences in the reliability of echo
measures affecting their accuracy for dysynchrony screening.
However, echo (TDI) is reliable if used properly.

Source: Echocardiography. 2007 Jan;24(1):40-6.
Title: Reliability of echocardiographic indices of dyssynchrony.
Authors: Gabriel RS, Bakshi TK, Scott AG, Christiansen JP, Patel
H, Wong SP, Armstrong GP.
PMID: 17214621.