How accurate is visual assessment of synchronicity in myocardial motion? An in vitro study with computer-simulated regional delay in myocardial motion: Clinical implications for rest and stress echocardiography studies

Asynchronicity ih. echocardiographic images is normally assessed visually. No prior quantitative studies have determined the limitations of this appro ach. To quantify visual recognition of myocardial asynchronicity in echocar diographic images, computer-simulated delay phantom loops were generated fr om a 3.3 MHz digital image data from a normal left ventricular short-axis h eart cycle acquired at 55 frames per second. Slit expect observers visually assessed 30 abnormal and 3 normal loops with differing computer-induced de lay patterns on 3 occasions and in this optimally simulated environment cou ld recognize only single delays of 89 ms or more, This was improved to 71 m s or more by use of side-by-side (normal versus abnormal) comparative revie w. Thus visual assessment of clinically important regional delay in rest or stress echo images is limited.