DOI: 10.1111/j.1540-8175.2010.01156.x C  2010, Wiley Periodicals, Inc. Ventricular Asynchrony of Time-to-Peak Systolic Velocity in Structurally Normal Heart by Tissue Doppler Imaging Hakimeh Sadeghian, M.D., ∗ Farzaneh Ahmadi, M.D., ∗ Masoumeh Lotfi-Tokaldany, M.D.,† Ali Kazemisaeid, M.D.,‡ Mahmood Sheikh Fathollahi, Ph.D.,† and Hamidreza Goodarzynejad, M.D.† ∗ Echocardiography Department, †Research Department, and ‡Electrophysiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Background: Echocardiographic measurements of time-to-peak systolic velocities (Ts) are helpful for assessing the degree of cardiac asynchrony. We assessed the degree of ventricular asynchrony in struc- turally normal heart according to Ts by tissue Doppler imaging. Methods: We performed conventional echocardiography and tissue velocity imaging for 65 healthy adult volunteers to measure the Ts of 12 left ventricular segments in the mid and basal levels delay of Ts and standard deviation (SD) of Ts in all and basal segments. Six frequently used markers of dyssynchrony were measured and were also compared between men and women. Data are presented as median (25th and 75th percentile). Results: Septal-lateral and anteroseptal-posterior delays were 50 (20, 90) and 20 (0, 55) ms. The delay between the longest and the shortest Ts in basal and all segments were 100 (80, 120) and 110 (83, 128) ms, respectively. SD of Ts was 39 (24, 52) ms for basal and 41 (28, 51) ms for all segments. Overall, 76.9% of cases had at least one marker of dyssynchrony. Frequencies of dyssynchrony markers were almost significantly higher in women compared to men. The most frequently observed dyssynchrony marker was SD of Ts of all segments (70.8%) and the lowest was anteroseptal-posterior delay (21.5%). Conclusions: Normal population almost had dyssynchrony by previously described markers and many of these markers were more frequent in women. Conducting more studies on normal population by other tissue Doppler modalities may give better description of cardiac synchronicity. (Echocardiography 2010;27:823-830) Key words: tissue Doppler imaging, tissue velocity imaging, echocardiography In the field of cardiovascular imaging, there is an increasing interest in the regional timing of tissue velocities of left ventricle (LV) in nor- mal heart, as it may provide beneficial informa- tion for evaluation of diseased heart. A promising clinical application from measuring time intervals by tissue velocity imaging (TVI) is the assessment of patients eligible for cardiac resynchronization therapy (CRT) by evaluating the time intervals be- tween peak systolic velocities of different areas of the ventricular wall. Normal reference values for time intervals are needed for this assessment. These values for normal human heart have been reported in limited studies. 1–5 More recent ob- servations on normal hearts show different re- sults compared with previously published stud- ies. 3–5 Furthermore, new findings suggest that tissue Doppler derived systolic synchrony is af- fected by gender and age. 3 Address for correspondence and reprint requests: Ma- soumeh Lotfi-Tokaldany, M.D., Research Department, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Street, Tehran, Iran. Fax: +98-21-88029256; E-mail: lotfi21366@yahoo.co.uk The aim of this study was to measure time- to-peak myocardial systolic velocities of different LV segments by TVI and to evaluate intraventricu- lar delay in structurally normal heart with respect to previously described markers of dyssynchrony. Comparison of time intervals between male and female individuals was the second goal of this study. Methods: Study Population: The study group consisted of 65 healthy young adult volunteers aged 20–53 years (mean age of 30.06 ± 7.54 years, 34 male and 31 female), who were judged to be free of any acute or chronic illness through history and physical exam- ination. All subjects had normal surface electro- cardiogram and transthoracic echocardiographic findings. Subjects were excluded if they had a history of coronary artery disease, hypertension, diabetes mellitus, and taking regular medica- tion. This study was approved by the institutional ethics review board of the hospital. 823