{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:14:33Z","timestamp":1761059673099},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,2,8]],"date-time":"2014-02-08T00:00:00Z","timestamp":1391817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2014,10]]},"abstract":"Background<\/jats:title>Mechanical discoordination (MD<\/jats:styled-content>) is known as a myocardial deformation of opposite strain during ejection, reflecting dyssynchronous electrical activation. We used speckle\u00a0tracking echocardiography to examine the relationship between MD<\/jats:styled-content>, left ventricular (LV<\/jats:styled-content>) function and geometry, as well as electrical dyssynchrony in various nonischemic hearts.<\/jats:p><\/jats:sec>Methods and Results<\/jats:title>We examined 131 subjects (left bundle branch block [LBBB<\/jats:styled-content>] 27; dilated cardiomyopathy [DCM] without LBBB<\/jats:styled-content> 33; LV<\/jats:styled-content> hypertrophy 28; and normal heart 43) using circumferential strain rate analysis. Integration of positive (stretch) and negative (shortening) components during the ejection time was obtained in the mid\u2010ventricular level for 6 myocardial segments, and MD<\/jats:styled-content> was quantified as the stretch to shortening ratio (SSR<\/jats:styled-content>). The SSR<\/jats:styled-content> in the septal region (anteroseptal and septal segments) was markedly elevated in the LBBB<\/jats:styled-content> and DCM groups compared with the other groups. With univariate analysis, SSR<\/jats:styled-content> over the septal region was found to be correlated with QRS<\/jats:styled-content> duration, LV<\/jats:styled-content> end\u2010diastolic dimension, and LV<\/jats:styled-content> ejection fraction. Multivariate analysis revealed that QRS<\/jats:styled-content> duration and LV<\/jats:styled-content> ejection fraction were significant independent determinants of SSR<\/jats:styled-content> for the septal region.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In nonischemic hearts, electrical dyssynchrony and LV<\/jats:styled-content> dysfunction may contribute synergistically to MD<\/jats:styled-content> in the septal region. The finding that non\u2010LBBB<\/jats:styled-content> DCM patients exhibited a certain amount of SSR<\/jats:styled-content> may provide new insight into therapeutic strategies for cardiac resynchronization therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.12538","type":"journal-article","created":{"date-parts":[[2014,2,8]],"date-time":"2014-02-08T12:36:43Z","timestamp":1391863003000},"page":"1077-1084","source":"Crossref","is-referenced-by-count":6,"title":["Left Ventricular Mechanical Discoordination in Nonischemic Hearts: Relationship with Left Ventricular Function, Geometry, and Electrical Dyssynchrony"],"prefix":"10.1111","volume":"31","author":[{"given":"Shinsaku","family":"Shimamoto","sequence":"first","affiliation":[{"name":"Department of Cardiology Osaka Medical College Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahide","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Cardiology Osaka Medical College Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shimpei","family":"Nogi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Osaka Medical College Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Kizawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Osaka Medical College Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobukazu","family":"Ishizaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology Osaka Medical College Osaka 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