Abstract: Abstract Objective: To investigate the clinical value of real-time three-dimensional echocardiography (RT3DE) in assessment of left ventricular systolic asynchrony in children. Methods: RT3DE was used to detect 55 normal children (control group), 10 patients with dilated cardiomyopathy (DCM group) and 22 patients with Kawasaki disease (KD group). The 16-segment myocardial systolic volume reached the lowest maximal difference (Tmsv16-Dif) and the standard deviation (Tmsv16-SD) were measured. To Values of Tmsv16-Dif and Tmsv16-SD were expressed as a percentage of the duration of the cardiac cycle (Tmsv16-Dif %, Tmsv16-SD %) to allow comparisons between patients with significantly different heart rate. Results: In control group, there was no significant difference in Tmsv16-Dif, Tmsv16-SD, Tmsv16-Dif % and Tmsv16-SD % between male and female patients. There was a significant difference in Tmsv16-Dif and Tmsv16-SD between different age groups, but no significant difference in Tmsv16-Dif % and Tmsv16-SD % between different age groups. The values of Tmsv16-Dif, Tmsv16-SD, Tmsv16-Dif % and Tmsv16-SD % were significantly higher in KD and DCM groups than those of control. The values of Tmsv16-Dif, Tmsv16-SD, Tmsv16-Dif % and Tmsv16-SD% were negatively correlated with left ventricular ejection fraction (LVEF) (r= –0.583, –0.565, –0.487 and –0.567, P<0.01). In control group, the RT3DE segmental time-volume curves showed in order, but they were disorder and the peak time-point spread in KD and DCM groups. Conclusion: Tmsv16-Dif% and Tmsv16-SD% of RT3DE can quantify global left ventricular mechanical dyssynchrony. RT3DE is a feasible and accurate method for analysis of left ventricular function.

Key words: Echocardiography, Real-time three-dimensional, Asynchrony, Left ventricle