Abstract 6116: Assessment of Global and Regional Left Ventricular Twist in Patients with Anterior Wall Myocardial Infarction Before and After Revascularization by 2-D Speckle Tracking Imaging

Background: Torsion of the left ventricle is related to myocardial architecture and contractility and is being evaluated as a sensitive marker of cardiac performance. New 2-D speckle tracking imaging (STI) may provide a powerful means of assessing LV torsion noninvasively. This study sought to evaluate the global and regional left ventricular twist in patients with anterior wall myocardial infarction (AMI) before and after revascularization by STI. Methods: A total of 50 subjects, including study group (n = 20) who underwent revascularization for AMI as well as 1 month after revascularization, and control group (n = 30) of normal individuals were studied using STI. LV twist was defined as apical rotation relative to the base. The peak LV twist, standard deviation of time to peak twist (Tw-SD) and maximal temporal difference of time to peak twist (Tw-diff) of 6 myocardial regions were measured. Results: Before revascularization, peak LV twist was significantly reduced while Tw-SD and Tw-diff significantly increased in patients with AMI as compared with normal control group ( P <0.001). One month after revascularization, these changes improved compared with pre- revascularization but remained diminished compared with normal controls (Table 1 ). There were significant correlations between LV peak twist and LVEF ( r =0.78, P <0.05), and LVEDD ( r =−0.63, P <0.05) in all subjects. Conclusion: LV twist measures significantly diminished and dys-synchronized in AMI patients prior to revascularization and improved after revascularization. STI measures correlate with EF and have the potential to quantify left ventricular global and segmental dysfunction in patients with AMI. Left ventricular regional and global peak twist, torsion and synchrony measures