Document Detail

Prolonged left ventricular twist in cardiomyopathies: a potential link between systolic and diastolic dysfunction.
MedLine Citation:
PMID:  21880606     Owner:  NLM     Status:  MEDLINE    
AIMS: Left ventricular (LV) twist and untwist play a major role in LV mechanics. We sought to acquire new pathophysiological insights in cardiomyopathies (CM) studying LV twist dynamics by speckle tracking imaging (STI).
METHODS AND RESULTS: Standard echo-Doppler and STI study were performed in 67 CM patients divided in four age- and sex-matched subgroups: 18 with apical hypertrophic cardiomyopathy (Group A); 20 with asymmetrical hypertrophic cardiomyopathy (Group B); 15 with dilated cardiomyopathy (Group C); 14 with LV non-compaction (Group D). As controls, 34 age- and sex-matched normal subjects were studied. Compared with control group, all CM Groups showed significantly lower longitudinal, circumferential, and radial myocardial deformations (P < 0.05). LV twist was correlated with ejection fraction (EF; r = 0.62; P < 0.0001). Furthermore, all CM patients had a significantly lower twist rate (P < 0.05) and delayed onset of untwist (P < 0.01). Of interest a significant correlation was found between isovolumic relaxation time and untwist onset (r= 0.485, P < 0.0001). In addition, a significant correlation was found between longitudinal deformations and the onset of untwist (strain: r = 0.46, P = 0.0001; strain rate: r = 0.33, P = 0.0056) and between longitudinal strain rate and twisting rate (r= -0.38; P = 0.0015).
CONCLUSION: (i) All CM patients show an impairment of longitudinal, circumferential, and radial myocardial deformations; (ii) LV peak twist is impaired only in CM with reduced EF but preserved in those with normal or increased EF; (iii) LV twist is prolonged and untwisting onset is delayed in all CM, suggesting that a mechanical adaptation to subclinical systolic abnormalities might induce, by a prolonged LV twist, the early onset of diastolic dysfunction.
Giuseppe Pacileo; Luca Baldini; Giuseppe Limongelli; Giovanni Di Salvo; Maria Iacomino; Cristina Capogrosso; Alessandra Rea; Antonello D'Andrea; Maria Giovanna Russo; Raffaele Calabrò
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Publication Detail:
Type:  Journal Article     Date:  2011-08-30
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  12     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-17     Completed Date:  2012-05-16     Revised Date:  2012-10-05    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  841-9     Citation Subset:  IM    
Department of Cardiology, 2nd University of Naples, Monaldi Hospital, Via Leonardo Bianchi 1, Naples, Italy.
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MeSH Terms
Cardiomyopathies / physiopathology,  ultrasonography*
Case-Control Studies
Echocardiography, Three-Dimensional
Torsion Abnormality / physiopathology,  ultrasonography
Ventricular Dysfunction, Left / physiopathology,  ultrasonography*
Comment In:
Eur Heart J Cardiovasc Imaging. 2012 Sep;13(9):801; author reply 801-2   [PMID:  22467441 ]

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