Document Detail


Kinetics of left ventricular strains and torsion during incremental exercise in healthy subjects: the key role of torsional mechanics for systolic-diastolic coupling.
MedLine Citation:
PMID:  20581049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The dynamics of systolic and diastolic strains and torsional mechanics of the left ventricle (LV) and their relation to diastolic filling never have been evaluated at various exercise intensities.
METHODS AND RESULTS: Speckle tracking echocardiography was performed in 20 healthy sedentary subjects at rest and during a progressive submaximal exercise test at 20%, 30%, and 40% of maximal aerobic power. LV twist increased progressively with exercise intensity (10.5 ± 3.2 to 15.8 ± 4.5°; P<0.001), whereas longitudinal strain remained unchanged after the first workload, underlining the key role of torsional reserve in systolic-diastolic coupling during exercise. The increase in diastolic untwisting (-88.7 ± 34.2 to -182.9 ± 53.5 deg · s(-1); P<0.01) was correlated to enhanced systolic twist (R=0.61; P<0.001), and its magnitude of increase was significantly higher compared to diastolic longitudinal and circumferential strain rates (119 ± 64% versus 65 ± 44% and 57 ± 24%, respectively), emphasizing its contribution to diastolic filling. The timing of peak untwisting and the chronology of diastolic mechanical events were unchanged during effort. Untwisting was driven mainly by apical rotation and determined mitral opening and isovolumic relaxation time (R=0.47 and 0.61, respectively; P<0.001), whereas basal rotation and longitudinal and circumferential diastolic strain rates were major determinants of increased early diastolic filling (R=0.64, 0.79, and 0.81, respectively; P<0.001).
CONCLUSIONS: The use of speckle tracking echocardiography gives new insights into physiological adaptive LV mechanics during incremental exercise in healthy subjects, underlining the key role of torsional mechanics. It might be useful to better understand the mechanisms of diastolic dysfunction and exercise intolerance in various pathological conditions.
Authors:
Grégory Doucende; Iris Schuster; Thomas Rupp; Aliona Startun; Michel Dauzat; Philippe Obert; Stéphane Nottin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-25
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-15     Completed Date:  2010-10-04     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  586-94     Citation Subset:  IM    
Affiliation:
Physiology and Physiopathology of Cardio-vascular Adaptations to Exercise, Faculty of Sciences, Avignon, France.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Adolescent
Adult
Biomechanics
Blood Pressure
Cardiac Output
Diastole
Echocardiography, Doppler
Exercise*
Exercise Test
France
Heart Rate
Heart Ventricles / ultrasonography
Humans
Kinetics
Male
Myocardial Contraction*
Reference Values
Systole
Torsion, Mechanical
Ventricular Function, Left*
Young Adult

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


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