Document Detail


Effect of mechanical dyssynchrony and cardiac resynchronization therapy on left ventricular rotational mechanics.
MedLine Citation:
PMID:  18394452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Alterations in rotational mechanics can bring new aspects to the understanding of left ventricular (LV) dyssynchrony. The aims of this study were to investigate LV rotational mechanics in candidates for cardiac resynchronization therapy (CRT) and to assess the effect of CRT by speckle-tracking echocardiography. Fifty-four patients with heart failure and 33 healthy controls were studied. Thirty-three underwent CRT. Speckle tracking was applied to short- and long-axis views. Radial and longitudinal dyssynchrony were assessed as previously defined. Apical and basal rotations were measured as the average angular displacement about the LV central axis. LV twist and torsion were then calculated. Peak apical and basal rotation, peak LV twist and torsion, apical and basal rotation at aortic valve closure (AVC), and LV twist and torsion at AVC were significantly lower in patients than controls. Apical-basal rotation delay and AVC-to-peak LV twist interval were longer in patients and associated with decreased peak LV twist and LV twist at AVC, respectively. In patients, rotational indexes, particularly LV twist and torsion, were correlated strongly with radial dyssynchrony. LV torsion (cutoff 0.1 degrees /cm) and twist (cutoff 1 degrees ) at AVC had the highest sensitivity (90%) and specificity (77%) to predict CRT responders among all other parameters, including radial and longitudinal dyssynchrony. In conclusion, LV dyssynchrony is associated with discoordinate rotation of the apical and basal regions, which in turn significantly decreases peak LV twist and torsion and LV twist and torsion at AVC. CRT significantly restored the altered rotational mechanics in responders. These parameters have potential for predicting responders to CRT.
Authors:
Leyla Elif Sade; Ozlem Demir; Ilyas Atar; Haldun Müderrisoglu; Bülent Ozin
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-20
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1163-9     Citation Subset:  AIM; IM    
Affiliation:
University of Baskent Faculty of Medicine, Department of Cardiology, Ankara, Turkey. elifsade@baskent-ank.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiac Pacing, Artificial*
Case-Control Studies
Echocardiography / methods*
Female
Heart Ventricles / ultrasonography
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Myocardial Contraction / physiology
Predictive Value of Tests
Sensitivity and Specificity
Stroke Volume / physiology
Systole / physiology
Ventricular Dysfunction, Left / physiopathology,  therapy*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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