Age-related Changes in Left Ventricular Twist Assessed by Two-dimensional Speckle-tracking Imaging

Takeuchi, Masaaki; Nakai, Hiromi; Kokumai, Michiko; Nishikage, Tomoko; Otani, Shinichiro; Lang, Roberto M.

doi:10.1016/j.echo.2006.04.011

Cited by 150 publications

(155 citation statements)

References 27 publications

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“…No gender differences were noted in peak twist or untwisting velocities. 99,100 Another source of the restoring force that drives diastolic torsional recoil is systolic deformation within the sheet structure, the so-called shear strain, due to significant fibre shearing within the sheet planes during systole. 101 Measuring longitudinal or circumferential shear is another promising approach to the assessment of torsion with speckle tracking, allowing full assessment of overall deformation in addition to three-dimensional strains and investigation of regional differences in torsion.…”

Section: 66mentioning

confidence: 99%

Hypertension and heart failure: a dysfunction of systole, diastole or both?

et al. 2008

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The pathological myocardial hypertrophy associated with hypertension contains the seed for further maladaptive development. Increased myocardial oxygen consumption, impaired epicardial coronary perfusion, ventricular fibrosis and remodelling, abnormalities in long-axis function and torsion, cause, to a varying degree, a mixture of systolic and diastolic abnormalities. In addition, chronotropic incompetence and peripheral factors such as lack of vasodilator reserve and reduced arterial compliance further affect cardiac output particularly on exercise. Many of these factors are common to hypertensive heart failure with a normal ejection fraction as well as systolic heart failure. There is increasing evidence that these apparently separate phenotypes are part of a spectrum of heart failure differing only in the degree of ventricular remodelling and volume changes. Furthermore, dichotomizing heart failure into systolic and diastolic clinical entities has led to a paucity of clinical trials of therapies for heart failure with a normal ejection fraction. Therapies aimed at reversing myocardial fibrosis, and targets outside the heart such as enhancing vasodilator reserve and improving chronotropic incompetence deserve further study and may improve the exercise capacity of hypertensive heart failure patients. Hypertension heart disease with heart failure is simply not a dysfunction of systole and diastole. Other peripheral factors including heart rate and vasodilator response with exercise may deserve equal attention in an attempt to develop more effective treatments for this disorder.

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Section: 66mentioning

confidence: 99%

Hypertension and heart failure: a dysfunction of systole, diastole or both?

et al. 2008

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“…Left ventricular (LV) twist, defined as the wringing motion of the heart as the apex rotates with respect to the base around the LV long-axis, has an important role in LV ejection and filling [1,2]. The final stage of the development of myocardial architecture is characterized by the formation of compact myocardium and development of oppositely wound epicardial and endocardial myocardial fibre helices [3,4].…”

Section: Introductionmentioning

confidence: 99%

Left ventricular solid body rotation in non‐compaction cardiomyopathy: A potential new objective and quantitative functional diagnostic criterion?

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et al. 2008

European J of Heart Fail

116

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Background: Left ventricular (LV) twist originates from the interaction between myocardial fibre helices that are formed during the formation of compact myocardium in the final stages of the development of myocardial architecture. Since non-compaction cardiomyopathy (NCCM) is probably caused by intrauterine arrest of this final stage, it may be anticipated that LV twist characteristics are altered in NCCM patients, beyond that seen in patients with impaired LV function and normal compaction. Aims: The purpose of this study was to assess LV twist characteristics in NCCM patients compared to patients with non-ischaemic dilated cardiomyopathy (DCM) and normal subjects. Methods and results:The study population consisted of 10 patients with NCCM, 10 patients with DCM, and 10 healthy controls. LV twist was determined by speckle tracking echocardiography. In all controls and DCM patients, rotation was clockwise at the basal level and counterclockwise at the apical level. In contrast, in all NCCM patients the LV base and apex rotated in the same direction. Conclusions: These findings suggest that 'LV solid body rotation', with near absent LV twist, may be a new sensitive and specific, objective and quantitative, functional diagnostic criterion for NCCM.

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“…Peak rotation at the apex may range from 5.7º to 11.2º. Maximum systolic torsion in normal hearts has then been found to range from 6.1º to 14.5º (Helle-Valle et al 2005;Kanzaki et al 2006;Nakai et al 2006;Takeuchi et al 2006). An example of the rotational motion of a normal, healthy heart is presented in Figure 5 below.…”

Section: Rotational Motionmentioning

confidence: 98%