Document Detail

Left ventricular torsional dynamics in aortic stenosis: relationship between left ventricular untwisting and filling pressures. A two-dimensional speckle tracking study.
MedLine Citation:
PMID:  20053657     Owner:  NLM     Status:  In-Process    
AIMS: The contribution of left ventricular (LV) untwisting to LV suction and early-diastolic filling was previously demonstrated, but this was not yet tested in patients with aortic stenosis (AS). We sought to assess the relationship between LV untwisting and LV filling pressures in patients with severe AS and normal left ventricular ejection fraction (LVEF) using speckle tracking echocardiography.
METHODS AND RESULTS: Sixty-one consecutive patients (66 +/- 9 years) with severe AS, preserved LVEF (63 +/- 6%), and 40 normal subjects (47 +/- 12 years) were prospectively enrolled. A comprehensive echocardiographic examination was performed in all. LV rotation and twisting were assessed using speckle tracking echocardiography. Peak apical back rotation rate, peak LV untwisting rate, and time intervals from QRS onset (ECG) to each of them were measured. Brain natriuretic peptide (BNP) levels were determined in 30 patients. Patients with AS were older than normal subjects (P < 0.001). LV mass, LA volume, LV filling pressures as well as peak apical back rotation rate and time to peak apical back rotation rate were increased in patients (P < 0.05 for all). In patients with AS, both time to peak LV untwisting rate and time to peak apical back rotation rate were significantly related to E/E' ratio and to BNP levels (P < 0.04 for all).
CONCLUSION: In patients with severe AS and preserved LVEF, there is a significant relationship between LV untwisting and LV filling pressures, suggesting a role for impaired LV untwisting in the pathophysiology of diastolic dysfunction in this setting.
Bogdan A Popescu; Andreea Calin; Carmen C Beladan; Denisa Muraru; Monica Rosca; Dan Deleanu; Patrizio Lancellotti; Francesco Antonini-Canterin; Gian Luigi Nicolosi; Carmen Ginghina
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Publication Detail:
Type:  Journal Article     Date:  2010-01-06
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  11     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  406-13     Citation Subset:  IM    
'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
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