Effect of Aging on Twist-Displacement Loop by 2-Dimensional Speckle Tracking Imaging

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

doi:10.1016/j.echo.2006.02.007

Cited by 67 publications

(55 citation statements)

References 25 publications

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“…25,26,28,29 The reported values for LV twist ranged from 6.7° to 14.5°. In the present study, the twist values obtained from healthy volunteers of the same age and sex as patients with ASD were comparable to the data provided by Helle-Valle et al, 25 but higher than the data shown by Takeuchi et al 28 and Nakai et al 29 These differences are likely related to the definition of the apical slice, and our definition may be closer to the apex than in the studies by Takeuchi et al and Nakai et al Moore et al has shown that the positioning of the apical slice crucially affects the values that are measured for myocardial twist because rotation increases toward the apex. 30 Thus, the closer the apical slice is to the apex, the higher the values are for LV twist.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Dong

Zhang

Shu

et al. 2009

Circ J

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he secundum atrial septal defect (ASD) is a common form of congenital heart disease accounting for approximately 10% of children and 30% of adult patients with congenital cardiac defects. [1][2][3][4][5][6][7] Previous studies have demonstrated that right ventricular (RV) volume overload is associated with adverse left ventricular (LV) function in patients with ASD. [8][9][10] Recently, assessment of LV rotation has become an important approach for quantifying LV function. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] However, to the best of our knowledge there are no data available to date on the impact of RV volume overload on LV twist in patients with ASD. The recent development of 2-dimensional (D) ultrasound speckle tracking imaging (STI) has allowed LV torsional deformation to be evaluated noninvasively with validation against sonomicrometry and tagged magnetic resonance imaging (MRI). 25,26 In the present study, we sought to analyze LV twisting and untwisting using the novel STI method in adult patients with ASD. Methods Study SampleWe enrolled 45 asymptomatic adults (28±9 years, 13 males) with ASD. Inclusion criteria included age ≥18 years, isolated secundum ASD, evidence of RV volume overload and evidence of shunt on transthoracic echocardiogram. Patients were excluded if they were clinically unstable, were not in sinus rhythm at the time of echocardiographic examination, or had inadequate echocardiographic assessment. The ASD group was compared with an age-and sex-matched control group of normal subjects (n=45, 27±10 years, 13 males). The Institutional Review Board of the hospital approved the study, and all study participants provided informed consent before participation. Echocardiographic StudiesPatients were imaged in a supine position using a GE Vivid 7 ultrasound system with a M3S probe (1.7-3.4 MHz). The 2D grayscale images were acquired in the standard parasternal and apical views at a frame rate of 80-100 frames/s, and 3 cardiac cycles were recorded. Care was taken to obtain parasternal circular short-axis tomograms at basal (identified by the mitral valve) and apical (no papillary muscles noted) levels. All images were stored digitally for subsequent offline analysis. Conventional Echocardiographic AnalysisThe analysis was performed offline by a single observer without knowledge of hemodynamic data, using commercially available 2D strain software (Echopac PC, version 7.0, GE Vingmed Ultrasound, Horten, Norway). LV volumes (end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF)) were measured according to the recent guidelines of the American Society of Echocardiography. 27 Analysis of Twist MechanicsThe time interval from the R wave on the ECG to aortic

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Section: Discussionmentioning

confidence: 99%

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Dong

Zhang

Shu

et al. 2009

Circ J

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“…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. …”

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confidence: 99%

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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“…The recent development of 2-dimensional ultrasound speckle tracking imaging (STI) has allowed LV torsional deformation to be evaluated noninvasively in a variety of patient populations [15][16][17][18][19][20][21][22][23]. The accuracy of this novel technique has been validated with sonomicrometry and tagged magnetic resonance imaging (MRI) [24,25].…”

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Left ventricular torsional deformation in patients undergoing transcatheter closure of secundum atrial septal defect

Dong

Zhang

Shu

et al. 2009

Int J Cardiovasc Imaging

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Left ventricular (LV) torsional deformation plays an important role with respect to LV ejection and filling. However, no data are available on the impact of overload relief on LV torsional deformation after transcatheter ASD closure. This study sought to evaluate LV twist and untwisting before and early after device closure of ASD using the speckle tracking imaging (STI). We acquired basal and apical LV short-axis ultrasound images in 30 asymptomatic patients (29 +/- 9 years, 9 males) scheduled for percutaneous closure of an ASD before and 1-day after transcatheter ASD closure. All data were offline analyzed with Echopac 7.0 software. After transcatheter ASD closure, there was no significant difference in peak apical rotation and time to the peak (P > 0.05 for both). However, a significantly improved basal rotation was recorded, including significantly increased peak clockwise rotation (-7.1 +/- 3.2 degrees vs. -5.4 +/- 2.9 degrees , P = 0.014), decreased initial counterclockwise rotation (2.0 +/- 1.8 degrees vs. 5.1 +/- 3.2 degrees , P < 0.001) and shortened time to peak clockwise rotation (105.5 +/- 16.5% vs. 118.0 +/- 18.5% of systolic period, P = 0.001). LV twist was significantly improved in patients with ASD after the device closure (16.1 +/- 6.7 degrees vs. 12.2 +/- 6.3 degrees , P = 0.001), whereas there was no significant difference in peak untwisting rate, time to the peak and untwisting during IVRT (P > 0.05 for all). In conclusion, LV systolic twist could be significantly improved but diastolic untwisting remained unchanged after transcatheter ASD closure. This improvement was mainly attributed to the improved LV basal rotation rather than the unchanged apical rotation.

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Effect of Aging on Twist-Displacement Loop by 2-Dimensional Speckle Tracking Imaging

Cited by 67 publications

References 25 publications

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Alterations in Left Ventricular Untwisting With Ageing

Left ventricular torsional deformation in patients undergoing transcatheter closure of secundum atrial septal defect

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