Left ventricular rotational mechanics in hypereosinophilic syndrome—Analysis from the three‐dimensional speckle‐tracking echocardiographic MAGYAR‐Path Study

Abstract

Introduction: Hypereosinophilic syndrome (HES) is a very heterogeneous group ofdisorders with varied etiologies characterized by peripheral eosinophilia and eosinophilic tissue/end-organ damage. Three-dimensional speckle-tracking echocardiography (3DSTE) was used for assessment of left ventricular (LV) rotational mechanics in HES patients. Methods:The study comprised 13 HES patients, from which one patient was excluded due to insufficient image quality. The remaining patient population consisted of 12 HES cases (mean age: 59.7 ± 13.7 years, eight males). The control group consisted of 36 healthy volunteers (mean age: 52.9 ± 8.3 years, 23 males). 3DSTE was used for the evaluation of LV rotational abnormalities.Results: Both LV apical rotation (4.86 ± 1.92 degree vs 10.07 ± 3.92 degree, P < .0001) and LV twist (8.52 ± 2.79 degree vs 14.41 ± 4.26 degree, P < .0001) showed significant deteriorations in most of HES patients. Time-to-peak LV apical rotation (380 ± 115 ms vs 344 ± 69 ms, P = .56), LV basal rotation (335 ± 148 ms vs 337 ± 111 ms, P = .89), and LV twist (348 ± 91 ms vs 320 ± 60 ms, P = .64) were not significantly different between HES patients and controls. No correlations could be detected between absolute eosinophil count and eosinophil ratio and apical LV rotation (r = 0.12, P = .51 and r = 0.23, P = .45, respectively) and LV twist (r = 0.24, P = .39 and r = 0.31, P = .34, respectively). In two subjects, the absence of LV twist called LV "rigid body rotation" (RBR) was detected. Conclusions: Reduced LV apical rotation and twist could be demonstrated in HES.LV-RBR could be detected in some HES patients. K E Y W O R D S echocardiography, hypereosinophilic syndrome, left ventricular, rotation, speckle-tracking, three-dimensional, twist | 2065 NEMES Et al.

Normal values of left ventricular rotational parameters in healthy adults—Insights from the three‐dimensional speckle tracking echocardiographic MAGYAR‐Healthy Study

“…This phenomenon was first reported in noncompaction cardiomyopathy (NCCM). 29,30 Our group has reported this phenomenon in a number of pathological states such as cardiac amyloidosis, 31 acromegaly 32 and congenital heart diseases. [33][34][35] It is not known whether this is a sign of a yet subclinical pathology or undiagnosed disease; however, to the best of our knowledge, this phenomenon has not been previously reported in the healthy population.…”

The impact of lower body compression garment on left ventricular rotational mechanics in patients with lipedema—Insights from the three‐dimensional speckle tracking echocardiographic MAGYAR‐Path Study

“…This towel‐wringing‐like movement is responsible for ~40% of systolic pumping function 20 . LV twist is impaired is several pathologic conditions 22 and its absence (LV‐RBR) can be detected in large percent of patients with noncompaction cardiomyopathy 16 or cardiac amyloidosis 23 …”

Left ventricular rotational abnormalities following successful kidney transplantation—insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

“…Moreover, significant LV rotational abnormalities (LV-RBR) could also be confirmed in some KTx cases due to abnormally directed LV basal rotation. Recently these sorts of LV rotational abnormalities could be detected in high ratio of patients with noncompaction cardiomyopathy (55-100%) (20,21), cardiac amyloidosis (60%) (22), acromegaly (25%) (23), but reports showed similar cases with other diseases as well. Significant apicobasal gradient (overrotation of the LV apex) suggesting a compensating mechanism could also be detected in these cases similarly to what happens during stress (24).…”