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

Abstract

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.

Diastolic function of the left ventricle in patients with cardiomyopathy and low ejection fraction: the role of torsion in left bundle branch block

“…В экспериментальных работах на собаках было по-казано, что снижение апикального вращения про-исходит параллельно снижению деформации апи-кальных сегментов. При этом апикальная ротация по-степенно снижается и затем становится обратной, пас-сивно следуя за вращением базальных отделов [1,3,26]. Это положение также было продемонстрировано в нашем исследовании.…”

“…Спиральное строение миокарда, описанное Torrent-Guasp как непрерывная мышечная лента, играет важную роль в физиологии кардиального сокращения [1]. Подобная уникальная пространственная конфигу-рация миокарда обеспечивает анатомическую основу для максимально эффективной работы левого желу-дочка (ЛЖ).…”

New insights in LV torsion for the selection of cardiac resynchronisation therapy candidates

“…A speckle tracking study in 10 patients with dilated cardiomyopathy and 10 patients with non-compaction cardiomyopathy by Van Dalen et al [21] also reported about the occurrence of rigid body rotation. In both patient groups, 3 people had an electrical conduction delay (bundle branch block).…”

Advances in the assessment of left atrial function by three-dimensional speckle tracking echocardiography

“…were the first to demonstrate that 2DSTE-derived 'LV solid/rigid body rotation', with near absent LV twist, may be a new sensitive and specific, objective and quantitative, functional diagnostic criterion and have good predictive value for the diagnosis of NCCM (55,56). LV myocardial deformation was also found to be reduced in the longitudinal and circumferential dimensions and manifested tight systolic-diastolic coupling in children with NCCM (57).…”