Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography

Dalen, Bas van; Soliman, Osama Ibrahim Ibrahim; Vletter, Wim B.; Cate, Folkert J. ten; Geleijnse, Marcel L.

doi:10.1152/ajpheart.00513.2008

Cited by 83 publications

(79 citation statements)

References 32 publications

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“…24 However, LV twist increases with advancing age, probably because of subendocardial dysfunction. 9,21,25 The early diastolic release of increased potential energy stored during this augmented systolic twisting deformation may be the cause of the preserved peak diastolic untwisting velocity and untwisting rate with ageing found both in the current study and by Takeuchi et al 9 Our findings of strong, age-independent relationships between LV peak systolic twist and peak diastolic untwisting velocity and untwisting rate support this hypothesis. Nevertheless, although the peak diastolic untwisting velocity and untwisting rate did not change significantly, with advancing age both parameters were impaired when normalized for the increased extent of LV twist.…”

Section: Influence Of Ageing On LV Untwistingsupporting

confidence: 79%

“…20 Recently, an increase of LV twist with ageing, not only resulting from an increase in apical peak systolic rotation, but also from a decrease in rotational deformation delay, defined as the difference between the timing of LV basal and apical peak systolic rotation, was described by our group. 21 Besides the contribution of LV twist to LV ejection during systole, the potential energy stored in the twisted LV is rapidly released in early diastole, leading to swift recoil of the LV during isovolumic relaxation. Furthermore, still depolarized subendocardial fibers that are, in contrast to the systolic period, now not opposed by active contraction of the subepicardial fibers, may actively support this process.…”

Section: Influence Of Ageing On LV Untwistingmentioning

confidence: 99%

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Alterations in Left Ventricular Untwisting With Ageing

Dalen

Soliman

Kauer

et al. 2010

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp nderstanding age-associated changes of the cardiovascular system is important because these changes are an important precursor to cardiovascular disease. 1 Marked changes in left ventricular (LV) diastolic function are known to occur in normal, healthy, older people, 2,3 although the processes contributing to these changes are yet to be fully elucidated. The dynamic interaction of subendocardial and subepicardial fibers causes a twisting LV deformation during systole that leads to storage of potential energy. 4,5 Subsequent rapid untwisting during isovolumic relaxation decreases LV pressure, which makes effective sucking of blood into the LV possible once the mitral valve opens. 6 However, conflicting data have been published on the changes in the untwist rate and, in particular, the peak diastolic untwisting velocity with ageing. [7][8][9][10] In order to gain further insight into age-associated changes of LV diastolic function, the purpose of the current study was to investigate alterations in LV untwisting with ageing. Methods Study ParticipantsThe study population consisted of 75 healthy, non-obese (body mass index <27 kg/m 2 ) volunteers without hypertension, diabetes or regular use of medication for cardiovascular disease, with a normal 12-lead ECG, normal left atrial and LV dimensions, and LV ejection fraction by transthoracic echocardiography. None of the patients had complaints that were compatible with cardiac disease. All patients were required to have good echocardiographic image quality that allowed for complete analysis of LV rotation and twist by speckle-tracking echocardiography. Patients were primarily recruited from our department (personnel) or were family members or friends. The subjects were classified into 3 groups: aged 16-35 (Group 1, n=25), 36-55 (Group 2, n=25) and 56-75 (Group 3, n=25) years. Informed consent was given by all patients and the institutional review board approved the study. EchocardiographyTwo-dimensional grayscale harmonic images were obtained in the left lateral decubitus position using a commercially available ultrasound system (iE33, Philips, Best, The Netherlands) equipped with a broadband (1-5 MHz) S5-1 transducer (frequency transmitted 1.7 MHz, received 3.4 MHz). All echocardiographic measurements were averaged from 3 heartbeats. From the M-mode recordings the following data were acquired: left atrial size, LV end-diastolic septal and posterior wall thicknesses, and LV end-diastolic and end-systolic dimensions. The LV ejection fraction was calculated from Background: In order to gain further insight into age-associated changes of left ventricular (LV) diastolic function, the purpose of the current study was to investigate alterations in LV untwisting with ageing.

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Section: Influence Of Ageing On LV Untwistingsupporting

confidence: 79%

Section: Influence Of Ageing On LV Untwistingmentioning

confidence: 99%

Alterations in Left Ventricular Untwisting With Ageing

Dalen

Soliman

Kauer

et al. 2010

Circ J

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“…Care was taken to ensure that the basal short-axis plane contained the mitral valve and that the apical plane was acquired distally to the papillary muscle with the LV as circular as possible and proximal to the level with luminal obliteration at end systole (37). Analysis of LV strains and peak twist was conducted as previously described (25).…”

Section: Methodsmentioning

confidence: 99%

Progressive and biphasic cardiac responses during extreme mountain ultramarathon

Maufrais

Millet

Schuster

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

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Maufrais C, Millet GP, Schuster I, Rupp T, Nottin S. Progressive and biphasic cardiac responses during extreme mountain ultramarathon. Am J Physiol Heart Circ Physiol 310: H1340 -H1348, 2016. First published February 26, 2016 doi:10.1152/ajpheart.00037.2016.-Investigations on the cardiac function consequences of mountain ultramarathon (MUM) Ͼ100 h are lacking. The present study assessed the progressive cardiac responses during the world's most challenging MUM (Tor des Géants; Italy; 330 km; 24,000 m of cumulative elevation gain). Resting echocardiographic evaluation of morphology, function, and mechanics of left and right ventricle (LV and RV) including speckle tracking echocardiography was conducted in 15 male participants (46 Ϯ 13 yr) before (pre), during (mid; 148 km), and after (post) the race. Runners completed the race in 126 Ϯ 15 h. From pre to post, the increase in stroke volume (SV) (103 Ϯ 19 vs. 110 Ϯ 23 vs. 116 Ϯ 21 ml; P Ͻ 0.001 at pre, mid, and post) was concomitant to the increase in LV early filling (peak E; 72.9 Ϯ 15.7 vs. 74.6 Ϯ 13.1 vs. 82.1 Ϯ 11.5 cm/s; P Ͻ 0.05). Left and right atrial end-diastolic areas, RV end-diastolic area, and LV enddiastolic volume were 12-19% higher at post compared with pre (P Ͻ 0.05). Resting heart rate and LV systolic strain rates demonstrated a biphasic adaptation with an increase from pre to mid (55 Ϯ 8 vs. 72 Ϯ 11 beats/min, P Ͻ 0.001) and a return to baseline values from mid to post (59 Ϯ 8 beats/min). Significant correlations were found between pre-topost percent changes in peak E and LV end-diastolic volume (r ϭ 0.63, P Ͻ 0.05) or RV (r ϭ 0.82, P Ͻ 0.001) or atrial end-diastolic areas (r ϭ 0.83, P Ͻ 0.001). An extreme MUM induced a biphasic pattern of heart rate in parallel with specific cardiac responses characterized by a progressive increase in diastolic filling, biventricular volumes, and SV. IT IS WELL DOCUMENTED THAT prolonged intense exercise, such as a marathon or Ironman triathlon, transitorily alters cardiac function (7,13,20,22,23,28,42). A range of 3-15 h exercising induces transient left ventricular (LV) global systolic (20, 42) and diastolic (7,23,28) dysfunctions. This phenomenon, named exercise-induced cardiac fatigue (EICF), is generally associated with the release of biochemical markers of myocardial damage (13,22).Whereas the impact of races such as marathons or Ironman triathlons has been extensively described, few studies have explored cardiac function after ultraendurance exercise. After 24 -26 h of exercise, previous studies observed a depressed diastolic function (5,24,29,30,35). However, conflicting results were observed on systolic function because ejection fraction (EF) was either decreased (24, 29, 35) or unchanged (5, 30). Recently, we evaluated the cardiac function consequences of a mountain ultramarathon (MUM) (i.e., 38 Ϯ 5 h). It is important to note that an important decrease in velocity (e.g., large deceleration) has been reported in the MUM of the present study (34), caused by the combination of extreme distance and sleep d...

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“…Previous studies documented that the LV apex rotates earlier than the LV base at rest, 16,17,33 but information on timing of LV rotational events during exercise is missing.…”

Section: The Specific Roles Of Apical and Basal Rotationsmentioning

confidence: 99%

Kinetics of Left Ventricular Strains and Torsion During Incremental Exercise in Healthy Subjects

Doucende

Schuster

Rupp

et al. 2010

Circ: Cardiovascular Imaging

119

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Background-The dynamics of systolic and diastolic strains and torsional mechanics of the left ventricle (LV) and their relation to diastolic filling never have been evaluated at various exercise intensities. Methods and Results-Speckle tracking echocardiography was performed in 20 healthy sedentary subjects at rest and during a progressive submaximal exercise test at 20%, 30%, and 40% of maximal aerobic power. LV twist increased progressively with exercise intensity (10.5Ϯ3.2 to 15.8Ϯ4.5°; PϽ0.001), whereas longitudinal strain remained unchanged after the first workload, underlining the key role of torsional reserve in systolic-diastolic coupling during exercise. The increase in diastolic untwisting (Ϫ88.7Ϯ34.2 to Ϫ182.9Ϯ53.5 deg ⅐ s Ϫ1 ; PϽ0.01) was correlated to enhanced systolic twist (Rϭ0.61; PϽ0.001), and its magnitude of increase was significantly higher compared to diastolic longitudinal and circumferential strain rates (119Ϯ64% versus 65Ϯ44% and 57Ϯ24%, respectively), emphasizing its contribution to diastolic filling. The timing of peak untwisting and the chronology of diastolic mechanical events were unchanged during effort. Untwisting was driven mainly by apical rotation and determined mitral opening and isovolumic relaxation time (Rϭ0.47 and 0.61, respectively; PϽ0.001), whereas basal rotation and longitudinal and circumferential diastolic strain rates were major determinants of increased early diastolic filling (Rϭ0.64, 0.79, and 0.81, respectively; PϽ0.001). Conclusions-The use of speckle tracking echocardiography gives new insights into physiological adaptive LV mechanics during incremental exercise in healthy subjects, underlining the key role of torsional mechanics. It might be useful to better understand the mechanisms of diastolic dysfunction and exercise intolerance in various pathological conditions. (Circ Cardiovasc Imaging. 2010;3:586-594.)

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Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography

Cited by 83 publications

References 32 publications

Alterations in Left Ventricular Untwisting With Ageing

Alterations in Left Ventricular Untwisting With Ageing

Progressive and biphasic cardiac responses during extreme mountain ultramarathon

Kinetics of Left Ventricular Strains and Torsion During Incremental Exercise in Healthy Subjects

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