To investigate the value of tissue motion mitral annular displacement (TMAD) in assessment of left ventricular systolic synchrony in patients with dilated cardiomyopathy (DCM).

Thirty-eight DCM patients and 30 healthy subjects were enrolled in this study. The left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), and left ventricular ejection fraction (LVEF) in two groups were investigated using conventional echocardiographyexamination.The time of systolic mitral annular peak displacement (TP) in two groups were measured by the technique of TMAD at six sites (anteroseptal, posteroseptal, anterior, lateral, posterior and inferior). The standard deviation of TP (TP-SD) and the maximal difference of TP (TP-DIF) were calculated. And the correlation between TP-SD and LVEF as well as TP-DIF and LVEF in the DCM group were analyzed. The standard deviation and maximal difference of the time to point with minimal systolic volume of 16 segments (Tmsv16-SD, Tmsv16-DIF) of the DCM group were measured by the technique of real-time three-dimensional echocardiography (RT-3D) . And the correlation between Tmsv-16SD and TP-SD as well as Tmsv16-DIF and TP-DIF were analyzed.

Compared with the healthy subjects, LVESV and LVEDV increased (t=14.023, 16.643, P<0.01) and the LVEF decreased significantly (t=26.112, P<0.01) in the DCM group. TP, TP-SD and TP-DIF in the DCM group obviously increased (t=7.628, 6.869, 7.507, 6.616, 5.631, 4.738, 7.368, 5.777, 6.781, P<0.01). TP-SD and TP-DIF were negatively correlated with LVEF (r=-0.645, -0.513, P<0.05), while TP-SD and Tmsv16-SD, TP-Dif and Tmsv16-Dif were positively correlated(r=0.643, P<0.01; r=0.563, P<0.05).

In this study, the TMAD technique was used to measure the time of peak displacement of mitral annulus to evaluate the synchrony of left ventricle movement. It is expected to be a new method in evaluation of the synchrony of left ventricle, which is simple, feasible approach without angle dependence.