Age-related Changes in the Left Ventricular Twist

Abstract

Introduction: Left ventricular (LV) rotation and twist play important roles in LV contraction and relaxation. Systolic function is usually preserved with aging, but diastolic function deteriorates. The aim of this study was to establish a reference value for LV twist and examine the effect of aging on it. Patients and Methods:We enrolled 75 healthy subjects who were divided into two groups according to age: < 40 and > 40 years. LV rotation and twist were assessed with two-dimensional speckle tracking imaging at the basal and apical levels of the parasternal short axis. LV twist was defined as an apical rotation relative to the baseline. Exclusion criteria included a history of ischemic and valvular disease, arrhythmia, use of a pacemaker, and systolic dysfunction.Results: Peak A wave velocity (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001) and E/E'ratio (7.7 ± 2.2 vs. 6.1 ± 1.3, p< 0.001) were higher and peak E wave velocity (52.4 ± 16 vs. 76.8 ± 11, p< 0.001) and E/A ratio (0.75 vs. 1.34, p< 0.001) were lower in old patients than in young patients. There was an increase in apical rotation (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) and a decrease in basal rotation (−4.1 ± 2.7° vs. −5.2 ± 3.7°, p= 0.185) in old patients, but these changes indicated no significant difference. With aging, the twist increased (8.6 ± 3.3° vs. 8.5 ± 4.1°, p= 0.890), but not significantly. LV apical rotation (5 ± 3.2 vs. 2.4 ± 1.1, p= 0.004) and twist (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) decreased in the old group with an increasing degree of LV diastolic dysfunction. Bulgular: Yaşlılarda gençlere kıyasla pik A dalga hızı (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001), E/E' oranı (7.7 ± 2.23 vs. 6.09 ± 1.3, p< 0.001) daha yüksek, pik E dalga hızı (52.4 ± 16 vs. 76.75 ± 11, p< 0.001), E/A oranı (0.75 vs. 1.34, p< 0.001) daha düşüktü. Yaşlı grupta apikal rotasyonda artış (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) ve bazal rotasyonda azalma (-4.1 ± 2.7° vs. 3.7°± -5.2, p= 0.185) izlendi ancak, bu değişiklikler anlamlı değildi. Yaşlanma ile birlikte, büküm önemsiz derecede arttı (8.6 ± 3.3° vs. 8.53 ± 4.1°, p= 0.890). Yaşlı grupta LV diyastolik disfonksiyon derecesi arttıkça apikal rotasyon (5.02 ± 3.2 vs. 2.4 ± 1.1, p= 0.004) ve büküm (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) azaldı.Sonuç: Bu çalışma LV bükümün yaşla birlikte hafifçe arttığını, ancak bu etkinin sistolik fonksiyonları normal olsada artmış diyastolik disfonksiyon varlığında tersine döndüğünü gösterdi.