| Preload dependency of left ventricular torsion: the impact of normal saline infusion. | |
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MedLine Citation:
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PMID: 20826594 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: left ventricular (LV) rotation results from contraction of obliquely oriented myocardial fibers. The net difference between systolic apical counterclockwise rotation and basal clockwise rotation is left ventricular torsion (LVT). Although LVT is altered in various cardiac diseases, determinants of LVT are incompletely understood. METHODS AND RESULTS: LV end-diastolic volume, LV apical and basal rotation, peak systolic LVT, and peak early diastolic untwisting rate were measured by speckle-tracking echocardiography in healthy subjects (n=8) before and after infusion of a weight-based normal saline bolus (2.1±0.3 L). Saline infusion led to a significant increase in end-diastolic LV internal diameter (45.9±3.7 versus 47.6±4.2 mm; P=0.002) and LV end-diastolic volume (90.0±21.6 versus 98.3±19.6 mL; P=0.01). Stroke volume (51.3±10.9 versus 63.0±15.5 mL; P=0.003) and cardiac output (3.4±0.8 versus 4.4±1.5 L/min; P=0.007) increased, whereas there was no change in heart rate and blood pressure. There was a significant increase in the magnitude of peak systolic apical rotation (7.5±2.4° versus 10.5±2.8°; P<0.001) but no change in basal rotation (-4.1±2.3° versus -4.8±3.1°; P=0.44). Accordingly, peak systolic LVT increased by 33% after saline infusion (11.2±1.3° versus 14.9±1.7°; P<0.001). This saline-induced increase in LVT was associated with a marked increase in peak early diastolic untwisting rate (72.3±21.4 versus 136.8±30.0 degrees/s; P<0.001). CONCLUSIONS: peak systolic LVT and peak early diastolic untwisting rate are preload-dependent. Changes in LV preload should be considered when interpreting results of future LVT studies. |
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Authors:
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Rory B Weiner; Arthur E Weyman; Abigail May Khan; Jason S Reingold; Annabel A Chen-Tournoux; Marielle Scherrer-Crosbie; Michael H Picard; Thomas J Wang; Aaron L Baggish |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-09-08 |
Journal Detail:
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Title: Circulation. Cardiovascular imaging Volume: 3 ISSN: 1942-0080 ISO Abbreviation: Circ Cardiovasc Imaging Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-18 Completed Date: 2010-12-23 Revised Date: 2011-09-06 |
Medline Journal Info:
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Nlm Unique ID: 101479935 Medline TA: Circ Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 672-8 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Massachusetts General Hospital, Boston, Mass., USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analysis of Variance Cardiac Volume / drug effects Echocardiography, Doppler, Color / methods Female Heart Ventricles / ultrasonography Humans Image Interpretation, Computer-Assisted / methods* Infusions, Intravenous Male Myocardial Contraction / drug effects* Observer Variation Reference Values Sodium Chloride / pharmacology* Torsion Abnormality / therapy*, ultrasonography* Ventricular Dysfunction, Left / physiopathology, ultrasonography* Ventricular Function, Left / drug effects* |
| Grant Support | |
ID/Acronym/Agency:
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1 UL1 RR025758-01/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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