Left Ventricular Apical Rotation, but Not Basal Rotation is Impaired in Patients with Dilated Cardiomyopathy

2005 ◽  
Vol 11 (9) ◽  
pp. S292 ◽  
Author(s):  
Eizo Akagawa ◽  
Kazuya Murata ◽  
Hideki Kunichika ◽  
Yasuyuki Hadano ◽  
Nobuaki Tanaka ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Apical Rotation ◽  
Basal Rotation

Abstract 3186: Right Ventricular Apical Pacing Impairs Left Ventricular Apical and Basal Rotation and Induces Apical-Basal Rotation Dyssynchrony

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ken Matsuoka ◽  
Masami Nishino ◽  
Masahiko Hara ◽  
Shinpei Nakatani ◽  
Akihito Hashimoto ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Systolic Dysfunction ◽  
Pacemaker Implantation ◽  
Acute Effect ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Apical Rotation ◽  
Av Conduction ◽  
Basal Rotation

Backgrounds: Although right ventricular apical (RVA) pacing has been reported to result in asynchronous patterns of left ventricular (LV) contraction reducing the LV ejection fraction (EF), LV torsion in RVA pacing has been unknown. We hypothesized that RVA pacing impairs rotation of LV apex and base and synchrony between LV apical and basal rotation, leading to the reduction of LV torsion. Methods: We studied 30 adult patients with sick sinus syndrome who had undergone DDD pacemaker implantation. Right ventricular pacing leads were positioned at the right ventricular apex. Changing from the intrinsic AV conduction to RVA pacing, we assessed the acute effect on echocardiac parameters; LV EF, tissue Doppler imaging (TDI) derived intraventricular delay, LV rotation and torsion, and LV apical-basal rotation dyssynchrony. Results: Results were shown in a table . Changing from the intrinsic AV conduction to RVA pacing, LV EF reduced (P=0.0003) and TDI derived intraventricular delay prolonged (P<0.0001). During RVA pacing, values of peak rotation in LV apex and LV base were significantly lower than those during intrinsic AV conduction (P=0.007 and 0.003, respectively). Correspondingly, LV torsion decreased significantly (P<0.0001). During the intrinsic AV conduction, LV apex and base rotated at the almost same time, while, during RVA pacing, LV basal rotation was delayed as compared to LV apical rotation. Consequently, apical-basal rotation dyssynchrony during RVA pacing was significantly longer than that during the intrinsic AV conduction (P=0.02). Conclusion: RVA pacing decreases LV rotation and torsion and induces LV apical-basal rotation dyssynchrony, resulting in partially LV systolic dysfunction. Comparison between Intrinsic AV Conduction and RVA Pacing

scholarly journals P333 Left ventricular rotational abnormalities in hypereosinophilic syndrome as assessed by three-dimensional speckle-tracking echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Nemes ◽  
A Kormanyos ◽  
I Marton ◽  
P Domsik ◽  
A Kalapos ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Hypereosinophilic Syndrome ◽  
Three Dimensional ◽  
Organ Damage ◽  
Left Ventricular ◽  
Diagnostic Methods ◽  
Control Group ◽  
Apical Rotation ◽  
Basal Rotation

Abstract Introduction Hypereosinophilic syndrome (HES) is a very heterogeneous group of disorders with varied etiologies characterized by peripheral eosinophilia and eosinophilic tissue/end-organ damage. In the present study, the ability of a novel non-invasive clinical tool, three-dimensional speckle-tracking echocardiography (3DSTE) was investigated to reveal any change in left ventricular (LV) rotational mechanics in clinically asymptomatic HES patients without manifest organ damage as determined by conventional diagnostic methods. Methods The present study comprised 13 patients established diagnosis of HES. However, one patient with idiopathic HES has been excluded due to insufficient image quality. The remaining patient population contained 11 cases with idiopathic HES and one patient with acute T-lymphoma associated HES (mean age: 59.7 ± 13.7 years, 8 males). The control group consisted of 36 healthy volunteers (mean age: 52.9 ± 8.3 years, 23 males). All HES patients and controls underwent complete two-dimensional Doppler echocardiography and 3DSTE. Results Both LV apical rotation (4.86 ± 1.92 degree vs. 10.07 ± 3.92 degree, p &lt; 0.0001) and LV twist (8.52 ± 2.79 degree vs. 14.41 ± 4.26 degree, p &lt; 0.0001) showed significant deteriotations in most of HES patients. In 2 subjects absence of LV twist called as LV „rigid body rotation’ (RBR) was detected. One patient had 1.77 degree counterclockwise (abnormally directed) LV basal rotation and 14.29 degree counterclockwise (normally directed) LV apical rotation resulting in 12.59 degree LV apico-basal gradient. The other patient had normally directed -2.09 degree LV basal rotation and almost zero (-0.27 degree) LV apical rotation resulting in 1.82 degree LV apico-basal gradient. Conclusions Reduced LV apical rotation and twist could be demonstrated in HES. LV-RBR could be detected in some HES patients.

scholarly journals Left ventricular remodelling and torsional dynamics in dilated cardiomyopathy: reversed apical rotation as a marker of disease severity

2009 ◽  
Vol 11 (10) ◽  
pp. 945-951 ◽  
Author(s):  
Bogdan A. Popescu ◽  
Carmen C. Beladan ◽  
Andreea Călin ◽  
Denisa Muraru ◽  
Dan Deleanu ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Disease Severity ◽  
Left Ventricular ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
Apical Rotation

scholarly journals Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001458
Author(s):  
Aisling Smith ◽  
Neidin Bussmann ◽  
Phillip Levy ◽  
Orla Franklin ◽  
Naomi McCallion ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Left Ventricular ◽  
Strong Positive Correlation ◽  
Term Infants ◽  
Time Points ◽  
Apical Rotation ◽  
Extremely Preterm ◽  
Basal Rotation ◽  
Rotational Mechanics

ObjectiveLeft ventricle (LV) rotational mechanics is an emerging tool to characterise LV function, but warrants further evaluation in neonates. The aim of this study was to compare LV rotational mechanics between term and extremely preterm babies over the first week of age.MethodsIn this prospective study, we serially assessed LV rotational parameters in 50 term infants and compared them with a historical dataset of 50 preterm infants born <29 weeks gestation. LV basal and apical rotation, LV twist, LV twist/untwist rate and torsion were derived using two-dimensional speckle tracking echocardiography at three time points over the first week of age.ResultsThere was no change in LV twist, LV torsion, basal rotation or apical rotation in term infants over the study period (all p>0.05). LV twist and torsion were higher in preterm infants, and increased over time. In preterm infants, basal rotation evolved from anticlockwise to clockwise rotation. Apical rotation remained anticlockwise in both groups (all p>0.05). LV twist rate (LVTR) and untwist rate was higher in preterm infants and increased over the three time points (all p>0.05). There was a strong positive correlation between LV torsion and LV untwist rate (LVUTR) in the entire cohort during the third scan.ConclusionTerm infants exhibit minimal LV twist which remains unchanged over the first week of age. This is in contrast to premature infants who demonstrate increasing indices of twist, torsion, LVTR and LVUTR over the first week, likely as a compensatory mechanism for reduced LV compliance.

scholarly journals Determinants of myocardial function characterized by CMR-derived strain parameters in left ventricular non-compaction cardiomyopathy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mareike Gastl ◽  
Alexander Gotschy ◽  
Malgorzata Polacin ◽  
Valery Vishnevskiy ◽  
Dominik Meyer ◽  
...  
Keyword(s):  
Strain Rate ◽  
Circumferential Strain ◽  
Myocardial Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Functional Changes ◽  
Apical Rotation ◽  
Basal Rotation ◽  
And Gender ◽  
Global Deformation

Abstract Clinical presentation of left ventricular non-compaction cardiomyopathy (LVNC) can be heterogeneous from asymptomatic expression to congestive heart failure. Deformation indices assessed by cardiovascular magnetic resonance (CMR) can determine subclinical alterations of myocardial function and have been reported to be more sensitive to functional changes than ejection fraction. The objective of the present study was to investigate the determinants of myocardial deformation indices in patients with LVNC. Twenty patients with LVNC (44.7 ± 14.0 years) and twenty age- and gender-matched controls (49.1 ± 12.4 years) underwent functional CMR imaging using an ECG-triggered steady state-free-precession sequence (SSFP). Deformation indices derived with a feature tracking algorithm were calculated including end-systolic global longitudinal strain (GLS), circumferential strain (GCS), longitudinal and circumferential strain rate (SRll and SRcc). Twist and rotation were determined using an in-house developed post-processing pipeline. Global deformation indices (GLS, GCS, SRll and SRcc) were significantly lower in patients with LVNC compared to healthy controls (all, p < 0.01), especially for midventricular and apical regions. Apical rotation and twist were impaired for LVNC (p = 0.007 and p = 0.012), but basal rotation was preserved. Deformation indices of strain, strain rate and twist correlated well with parameters of the non-compacted myocardium, but not with the total myocardial mass or the thinning of the compacted myocardium, e.g. r = 0.595 between GLS and the non-compacted mass (p < 0.001). In conclusion, CMR deformation indices are reduced in patients with LVNC especially in affected midventricular and apical slices. The impairment of all strain and twist parameters correlates well with the extent of non-compacted myocardium.

Reverse Left Ventricular Apical Rotation in Dilated Cardiomyopathy

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Zahra Ojaghi-Haghighi ◽  
Azin Alizadehasl ◽  
Arash Hashemi
Keyword(s):  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Apical Rotation

Evaluation of left ventricular torsion in children with hypertrophic cardiomyopathy

2013 ◽  
Vol 24 (2) ◽  
pp. 245-252 ◽  
Author(s):  
Christian Prinz ◽  
Lothar Faber ◽  
Dieter Horstkotte ◽  
Hermann Körperich ◽  
Axel Moysich ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Muscle Mass ◽  
Left Ventricular ◽  
Left Ventricular Torsion ◽  
Time To Peak ◽  
Concentric Hypertrophy ◽  
Apical Rotation ◽  
Ventricular Torsion ◽  
Basal Rotation ◽  
And Gender

AbstractAimsTo evaluate the role of torsion in hypertrophic cardiomyopathy in children.MethodsA total of 88 children with idiopathic hypertrophic cardiomyopathy (n = 24) and concentric hypertrophy (n = 20) were investigated with speckle-tracking echocardiography and compared with age- and gender-matched healthy controls (n = 44).ResultsIn hypertrophic cardiomyopathy, we found increased torsion (2.8 ± 1.6 versus 1.9 ± 1.0°/cm [controls], p < 0.05) because of an increase in clockwise basal rotation (−8.7 ± 4.3° versus −4.9 ± 2.5° [controls], p < 0.001) and prolonged time to peak diastolic untwisting (3.7 ± 2.4% versus 1.7 ± 0.6% [controls] of cardiac cycle, p < 0.01), but no differences in peak untwisting velocities. Hypertrophic cardiomyopathy patients demonstrated a negative correlation between left ventricular muscle mass and torsion (r = −0.7, p < 0.001). In concentric hypertrophy, torsion was elevated because of increased apical rotation (15.1 ± 6.4° versus 10.5 ± 5.5° [controls], p < 0.05) without correlation with muscle mass. Peak untwisting velocities (− 202 ± 88 versus −145 ± 67°/s [controls], p < 0.05) were higher in concentric hypertrophy and time to peak diastolic untwisting was delayed (1.8 ± 0.8% versus 1.2 ± 0.6% [controls], p < 0.05).ConclusionsIn contrast to an increased counterclockwise apical rotation in concentric hypertrophy, hypertrophic cardiomyopathy is characterised by predominantly enhanced systolic basal clockwise rotation. Diastolic untwisting is delayed in both groups. Torsion may be an interesting marker to guide patients with hypertrophic cardiomyopathy.

Abstract 4243: Assessment Of Physiologic And Pathologic Cardiac Hypertrophy By Two-dimensional Strain And Torsion Analysis

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Antonio Vitarelli ◽  
Mauro Bernardi ◽  
Giuseppe Placanica ◽  
Ysabel Conde ◽  
Simona D’Orazio ◽  
...  
Keyword(s):  
Heart Disease ◽  
Aortic Stenosis ◽  
Strain Rate ◽  
Healthy Volunteers ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Apical Rotation ◽  
Basal Rotation

PURPOSE . We sought to determine whether speckle tracking imaging (STI) could distinguish between subjects with athletic LVH and those with pathological LVH, such as occurs in hypertensive heart disease, hypertrophic cardiomyopathy (HCM), or aortic stenosis. METHODS . A total of 127 participants were studied, comprising competitive athletes (30), hypertensive heart disease (30), HCM (12), aortic stenosis (25), and healthy volunteers (30). Left ventricular mass index, ejection fraction, diastolic wall thickness, wall thickness ratio and diastolic and systolic wall-to-volume ratios were determined. LV longitudinal peak systolic strain (L-ϵ), peak systolic strain rate (SR-S), peak early diastolic strain rate (SR-E), and peak late diastolic strain rate (SR-A) values were measured by STI in the basal, mid and apical segments in apical 4-chamber view. LV radial strain (R-ϵ) in parasternal short-axis view was determined by STI. Averaged LV rotation and rotational velocities from the base and apex were also obtained (EchoPac, General Electric), and used for calculation of LV torsion (LVtor). RESULTS . Left ventricular (LV) mass indices were similar for all forms of LVH (p>.05), which were higher than those obtained in healthy volunteers (p<.05). Athletes had no significant differences in L-ϵ, SR-E and R-ϵ compared with control subjects (p = .21, .85, and .67, respectively). Patients with pathologic LVH had significantly decreased L-ϵ, SR-E, and R-ϵ (average septum: −15.9 ± 3.4%, 1.71 ± 0.35 s −1 , and 24.5 ± 11.6%, respectively) compared with control subjects (−22.4 ± 3.3%, 2.51 ± 0.49 s −1 , and 37.6 ± 15.2%, respectively; all p<.0005). LVtor increased significantly in pathologic LVH and in athletes compared to normals (p<.005 and .0001, respectively). In pathologic LVH LVtor increased mainly as a result of reduced basal rotation (−3.6±1.2 vs −6.4±1.5 degrees, p=.03). In athletes the LVtor increase was the result of an increase in both basal and apical rotation (basal rotation, −6.2±1.4 vs −9.1±1.6 degrees, p=.05; apical rotation, 16.9±3.1 vs 26.5±4.2 degrees, p=.08). CONCLUSIONS . Pathologic LVH has significant strain and SR-E reduction versus controls and a different pattern of LV torsion compared to athletes.

scholarly journals Postnatal neonatal myocardial adaptation is associated with loss of tolerance to tachycardia: a simultaneous invasive and noninvasive assessment

2016 ◽  
Vol 310 (5) ◽  
pp. H598-H607 ◽  
Author(s):  
Etienne Fortin-Pellerin ◽  
Nee S. Khoo ◽  
Lindsay Mills ◽  
James Y. Coe ◽  
Jesus Serrano-Lomelin ◽  
...  
Keyword(s):  
Atrial Tachycardia ◽  
Age Groups ◽  
Left Ventricular ◽  
Atrial Pacing ◽  
Apical Rotation ◽  
Filling Time ◽  
Basal Rotation ◽  
Preload Reduction ◽  
Myocardial Adaptation ◽  
The Impact

Doppler studies at rest suggest left ventricular (LV) diastolic function rapidly improves from the neonate to infant. Whether this translates to its response to hemodynamic challenges is uncertain. We sought to explore the impact of early LV maturation on its ability to tolerate atrial tachycardia. As tachycardia reduces filling time, we hypothesized that the neonatal LV would be less tolerant of atrial tachycardia. Landrace cross piglets of two age groups (1–3 days; NPs; 14–17 days, YPs; n = 7/group) were instrumented for an atrial pacing protocol (from 200 to 300 beats/min) and assessed by invasive monitoring and echocardiography. NPs maintained their LV output and blood pressure, whereas YPs did not. Although negative dP/d t in NPs at baseline was lower than that of YPs (−1,599 ± 83 vs. −2,470 ± 226 mmHg/s, respectively, P = 0.007), with increasing tachycardia negative dP/d t converged between groups and was not different. Both groups had similar preload reduction during tachycardia; however, NPs maintained shortening fraction while YPs decreased (NPs: 35.4 ± 1.4 vs. 31.8 ± 2.2%, P = 0.35; YPs: 31.4 ± 0.8 vs. 22.9 ± 0.8%, P < 0.001). Contractility measures did not differ between groups. Peak LV twist and untwisting rate also did not differ; however, NPs tended to augment LV twist through increased apical rotation and YPs through increasing basal rotation ( P = 0.009). The NPs appear more tolerant of atrial tachycardia than the YPs. They have at least similar diastolic performance, enhanced systolic performance, and different LV twist mechanics, which may contribute to improved tachycardia tolerance of NPs.

scholarly journals Dissecting Myocardial Mechanics in Patients With Severe Aortic Stenosis: 2-Dimensional vs 3-Dimensional–Speckle Tracking Echocardiography

2019 ◽  
Author(s):  
Xiaojun Bi ◽  
Husam M. Salah ◽  
Maria C. Arciniegas Calle ◽  
Jeremy J. Thaden ◽  
Lara F. Nhola ◽  
...  
Keyword(s):  
Normal Values ◽  
Severe Aortic Stenosis ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
3 Dimensional ◽  
Apical Rotation ◽  
Basal Rotation ◽  
2D And 3D

Abstract Background: Aortic valve stenosis (AS) commonly causes left ventricular (LV) pressure overload; thus, identifying patients with adverse remodeling/early LV dysfunction is critical. We compared 2-dimensional (2D) to 3-dimensional (3D) echocardiographic measures of LV myocardial deformation in patients with severe AS and studied the relation of LV preload and afterload (Zva) to myocardial deformation. Methods: We prospectively included 168 symptomatic patients (72±12 years) with severe AS and ejection fractions ≥50%. Strain parameters from those patients were compared with normal values found in the literature. 3D full-volume and 2D images were analyzed for global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), systolic strain rate (SRs), basal rotation (Rotmax-B), apical rotation (Rotmax-A), and peak systolic twist (Twistmax). Results: 2D–GLS and 2D–GCS decreased significantly compared with normal values (P˂.001 and P=.02, respectively); 2D Rotmax-B and Twistmax increased (P˂.001 vs normal values). Agreement between 2D–GLS and 3D–GLS by concordance correlation coefficient was 0.49 (95% CI, 0.39-0.57) in patients with AS. Both 2D– and 3D–GLS correlated with valvulo-arterial impedance (Zva) (r=0.34, P<.001; and r=0.23, P=.003, respectively). Conclusion: In patients with severe AS, GLS and GCS decreased, and basal rotation and twist increased to maintain LV ejection fraction. 2D– and 3D–GLS had a relatively fair agreement. Both 2D– and 3D–GLS correlated modestly with Zva.

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