Echocardiographic assessment of left ventricular mechanical dyssynchrony – A practical approach

Echocardiographic assessment of left ventricular mechanical dyssynchrony (LVMD) received great interest with the appearance of Cardiac resynchronization therapy ever since the first successful implants. Recent guidelines still keep QRS duration as the main selection criterion for diagnosing the presence of LVMD. However, measurement of QRS duration, which is an electrical phenomenon, seems to provide only a crude estimate on myocardial activation and is poorly correlated with the presence of LVMD. Echocardiography seems to be a more reliable tool for correctly identifying candidates for CRT and thus reducing the number of clinical non-responders.Recently LMVD was found to be associated with other cardiac and noncardiac diseases. Therefore, echocardiographic assessment of LVMD will always remain of importance.The aim of this article is to present a simplified, step-wise approach for the assessment of LVMD which can be easily followed and performed by echocardiographers to produce reliable, reproducible results for the assessment of LVMD.