Document Detail

Left ventricular rotation and twist assessed by four-dimensional speckle tracking echocardiography in healthy subjects and pathological remodeling: a single center experience.
MedLine Citation:
PMID:  23167548     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular (LV) twist represents a main aspect of ejection. It is defined as the difference between the apical and basal rotation and can be assessed by speckle tracking echocardiography (STE). Twist may be underestimated when assessed by two-dimensional-echocardiography due to the difficulty of identifying the real apex. Aim of this study was to evaluate the LV twist by means of three-dimensional (3D)-STE and verify if the inclusion of the apex can modify the assessment of the global twist.
METHODS: LV volume acquisition with a fully sampled matrix array transducer was performed in 30 healthy subjects and 79 patients with cardiomyopathy secondary to different etiologies. Thirty-nine patients had a LV ejection fraction (EF) ≥50% (Group A), 16 showed an EF between 40 and 50% (Group B), and 24 patients had an EF ≤40%(Group C). LV rotation was assessed by 3D-STE at basal, medium, apical, and apical-cap levels. Twist was computed considering the apex either at the apical level (Twist(Api) ) or at the apical-cap level (Twist(AC) ).
RESULTS: LV rotation resulted to be progressively higher from base to apical-cap (P < 0.0001) with a significant difference between the apex and the apical-cap level (6.20 ± 3.90° vs. 10.23 ± 7.52°; P < 0.001). Such a difference was constantly found in all Groups (P < 0.01 for Group A, P < 0.05 for Group B and C). Twist(Api) was also significantly lower than Twist(AC) both in the overall population (6.2 ± 3.89° vs. 10.23 ± 7.51°; P < 0.001) and in the different subgroups (
CONTROLS: 9.61 ± 3.39° vs. 13.75 ± 6.51°; Group A: 10.49 ± 4.77° vs. 16.37 ± 8.49°; Group B: 6.67 ± 3.44° vs. 9.14 ± 5.55°; Group C: 33 ± 2.62° vs. 5.26 ± 3.74°; P < 0.05 for all the comparisons).
CONCLUSIONS: Identification and inclusion of apical-cap is relevant for twist assessment and can be carried out efficiently by 3D-STE. The inclusion of the true apex in the calculation significantly affects the analysis of twist both in normal individuals and patients with different myocardial diseases.
Alessio Lilli; Marco Tullio Baratto; Jacopo Del Meglio; Marco Chioccioli; Massimo Magnacca; Enrica Talini; Maria Laura Canale; Rosa Poddighe; Alessandro Comella; Giancarlo Casolo
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-11-21
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  30     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-12     Completed Date:  2013-08-06     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  171-9     Citation Subset:  IM    
Copyright Information:
© 2012, Wiley Periodicals, Inc.
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MeSH Terms
Echocardiography, Four-Dimensional / methods*
Follow-Up Studies
Heart Ventricles / physiopathology,  ultrasonography*
Middle Aged
Myocardial Contraction / physiology*
Retrospective Studies
Stroke Volume / physiology*
Ventricular Dysfunction, Left / physiopathology,  ultrasonography*
Ventricular Function, Left*
Ventricular Remodeling*

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

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