Prevalence of left ventricular ‘rigid body rotation’, the near absence of left ventricular twist (insights from the MAGYAR studies)

Nemes, Attila; Kormányos, Árpád

doi:10.31083/j.rcm2301005

Cited by 7 publications

(9 citation statements)

References 55 publications

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“…Although a small number of dTGA patients were examined, differences in distribution of different mLV rotational patterns including above presented abnormalities could be detected late after Senning- and Mustard-procedures. mLV-RBR has been demonstrated to be associated with a number of diseases without obvious prognostic impact ( 19 ). In dTGA patients with normally directed mLV rotational mechanics, mLV basal rotation was found to be increased suggesting a compensatory mechanism resulting in a preserved mLV twist as compared to matched controls.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular rotational abnormalities in patients with transposition of the great arteries late after atrial switch operation: detailed analysis from the CSONGRAD Registry and MAGYAR-Path Study

Nemes¹,

Kormányos²,

Ruzsa³

et al. 2022

Cardiovasc Diagn Ther

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Background: Dextro-transposition of the great arteries (dTGA) is one of the most common cyanotic congenital heart defects, when the origins of the main arteries are switched in position. The present retrospective cohort study aimed three-dimensional speckle-tracking echocardiography-derived determination of apical and basal morphologic left ventricular (mLV) rotations and twist in adults with dTGA late after atrial switch. It was also purposed to compare whether differences in mLV rotational parameters were present in Senning-and Mustard-operated subjects.Methods: Sixteen dTGA patients were willing to participate late after atrial switch in this study, however, 6 subjects were excluded due to inferior image quality. The remaining group of 10 dTGA patients had a mean age of 29.4±8.8 years (5 males). Their clinical data were from the CSONGRAD Registry. Their results were compared to 24 age-and gender-matched healthy controls with a mean age of 34.4±12.6 years (14 males).Results: From the dTGA patient population, only 5 out of 10 subjects had normally directed mLV rotational mechanics, 5 dTGA cases had significant mLV rotational abnormality with counterclockwise mLV basal rotation in 4 patients (mLV rigid body rotation, mLV-RBR). One patient had complete reversal of apical and basal mLV rotations. Compared to the matched healthy controls, dTGA patients showed mLV-RBR significantly more frequently (50% vs. 0%, P=0.0009) regardless of the fact whether Senningor Mustard-procedure was performed. dTGA patients with normally directed mLV rotational mechanics proved to have increased mLV basal rotation (−7.9±4.1 vs. −3.7±1.9 degree, P=0.001) with preserved mLV twist (16.4±3.3 vs. 14.0±4.1 degree, P=ns) as compared to matched controls.Conclusions: Significant mLV rotational abnormalities are present in dTGA late after atrial switch procedures including mLV-RBR and reversed mLV twist. In dTGA patients with normally directed mLV rotational mechanics, mLV basal rotation is increased with preserved mLV twist. Some differences in mLV rotational abnormalities are present between Senning-and Mustard-procedures.

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Section: Discussionmentioning

confidence: 99%

Left ventricular rotational abnormalities in patients with transposition of the great arteries late after atrial switch operation: detailed analysis from the CSONGRAD Registry and MAGYAR-Path Study

Nemes¹,

Kormányos²,

Ruzsa³

et al. 2022

Cardiovasc Diagn Ther

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“…❖ In case of LV-RBR, LV twist could not be calculated, only LV apico-basal gradient. In cwLV-RBR basal and apical LV regions rotate in the same cw direction (LV apex rotates in not-normal opposite direction), while in ccwLV-RBR in the same ccw direction (LV base rotates in not-normal opposite direction) ( 11 ).…”

Section: Methodsmentioning

confidence: 99%

“…In normal circumstances, LV base and apex rotate in opposite clockwise (cw) and counterclockwise (ccw) directions, respectively, their net difference is called LV twist, which is considered to be an important part of systolic function of the LV ( 6 - 10 ). It is a known fact that certain pathologies may be associated with an absence of LV twist, when LV basal and apical regions rotate in the same cw or ccw direction, which is called LV ‘rigid body rotation’ (LV-RBR), but it can also occur in healthy subjects ( 11 ). Among modern imaging methods, three-dimensional speckle-tracking echocardiography (3DSTE) is suitable not only for accurate LV volumetric measurements according to the heart cycle, but also for characterizing LV deformation with strains and determining LV rotational features at the same time using the same 3D virtual models ideal for physiologic studies ( 12 - 16 ).…”

Section: Introductionmentioning

confidence: 99%

Left ventricular deformation in the presence of left ventricular ‘rigid body rotation’ in healthy adults—three-dimensional speckle-tracking echocardiographic insights from the MAGYAR-Healthy Study

Nemes,

Kormányos,

Ambrus

et al. 2024

Quant Imaging Med Surg

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Background During the heart cycle, the left ventricle (LV) not only shows a contraction-relaxation pattern, but LV has a rotational mechanics, as well. It is a known fact that certain pathologies may be associated with an absence of LV twist, when LV basal and apical regions rotate in the same clockwise (cw) or counterclockwise (ccw) direction called LV ‘rigid body rotation’ (LV-RBR), but it can also occur in healthy subjects. The present cohort study aimed to examine LV strains in healthy subjects with LV-RBR versus with normally directed LV rotational mechanics by three-dimensional speckle-tracking echocardiography (3DSTE). Methods The study consisted of 181 healthy individuals, from which 171 cases had normally directed LV rotational mechanics (mean age: 32.5±12.3 years, 79 males) and 10 healthy subject showed LV-RBR (mean age: 35.4±11.3 years, 3 males). Complete two-dimensional (2D) Doppler echocardiography and 3DSTE were performed in all healthy individuals. Results None of routine 2D Doppler echocardiographic parameters showed differences between the groups examined. There were no subjects with ≥ grade 1 regurgitation on any valves or with significant stenosis on any valves. 3DSTE-derived LV volumes, global and mean segmental strains did not differ between the groups examined. Apical anterior and lateral segments showed reduced segmental LV circumferential strain (CS) (−18.9%±8.5% vs. −26.7%±10.7%, P=0.02; −27.3%±12.6% vs. −34.8%±13.2%, P=0.08, respectively) and LV area strain (AS) (−26.8%±9.8% vs −36.8%±12.0%, P=0.01; −35.7%±13.2% vs. −45.0%±14.6%) in healthy subjects having LV-RBR as compared to cases with normally directed LV rotational mechanics. These abnormalities were present only in subjects having cwLV-RBR. Conclusions Although global LV deformation is normal in the presence of LV-RBR in healthy adults, reduction of apical anterior and lateral LV-CS (and LV-AS) are present in cases with cwLV-RBR only suggesting segmental deformation abnormalities.

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“…During diastole, the basal and apical LV regions move in the opposite directions, resulting in a motion called LV untwisting. In some cases, LV twist is missing when the rotation of the basal and apical parts of the LV is the oriented in the same direction, clockwise or counterclockwise, a phenomenon which is named LV "rigid body rotation" (LV-RBR) [25] (Figure 1). have not been included in the present review, which discusses only papers involving series of patients with HES.…”

Section: Under Healthy Circumstancesmentioning

confidence: 99%

Cardiac Mechanics and Valvular and Vascular Abnormalities in Hypereosinophilic Syndrome

Nemes

2024

JCM

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Hypereosinophilic syndrome (HES) is considered to be a rare myeloproliferative disease that is characterized by persistent eosinophilia with associated multiple-organ damage. The heart is often involved in HES, representing a major cause of morbidity and mortality. HES is a heterogeneous group of disorders; the majority of the cases are idiopathic. Summarizing the findings regarding myocardial, valvular, and vascular abnormalities in a series of patients with HES, most studies found normal left ventricular (LV) volumes with reduced LV global longitudinal strain and LV apical rotation and twist in HES cases, accompanied by increased left atrial (LA) volumes and stroke volumes, reduced peak LA circumferential strain (representing systolic abnormalities), and mitral annular dilation and functional deterioration. Regarding the right heart, preserved right ventricular volumes and functional properties, increased right atrial volumes, mild RA functional abnormalities, and dilated tricuspid annular dimensions without functional impairment could be seen in these studies. Aortic and pulmonary valves showed no specific disease-related alterations. Vascular abnormalities included increased aortic stiffness without dilation of the aorta and pulmonary hypertension in some cases. These results suggest disease-specific but relatively mild myocardial, valvular, and vascular abnormalities in HES. The present review aimed to summarize the available clinical data about cardiac mechanics and valvular and vascular abnormalities in a series of patients with HES.

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Prevalence of left ventricular ‘rigid body rotation’, the near absence of left ventricular twist (insights from the MAGYAR studies)

Cited by 7 publications

References 55 publications

Left ventricular rotational abnormalities in patients with transposition of the great arteries late after atrial switch operation: detailed analysis from the CSONGRAD Registry and MAGYAR-Path Study

Left ventricular rotational abnormalities in patients with transposition of the great arteries late after atrial switch operation: detailed analysis from the CSONGRAD Registry and MAGYAR-Path Study

Left ventricular deformation in the presence of left ventricular ‘rigid body rotation’ in healthy adults—three-dimensional speckle-tracking echocardiographic insights from the MAGYAR-Healthy Study

Cardiac Mechanics and Valvular and Vascular Abnormalities in Hypereosinophilic Syndrome

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