Left ventricular (LV) twist and untwisting rate are emerging as global and thorough parameters for assessment of LV function. This study explored differences of LV twist and untwisting rate in patients with acute myocardial infarction (AMI) and patients with ischemic and nonischemic chronic heart failure (HF). Fifty patients with AMI, 49 with ischemic HF, and 38 with nonischemic HF were studied. As a control group, 28 subjects without evidence of structural heart disease were included. Speckle-tracking analysis was applied to LV short-axis images at basal and apical levels. LV twist was defined as the net difference of apical and basal rotations at isochronal time points. The first time derivative of LV untwist was defined as the LV untwisting rate. Compared with control subjects, peak LV twist was decreased in patients with AMI and extremely decreased in those with HF (p <0.001, analysis of variance). A strong correlation (r = 0.87, p <0.001) was found between peak LV twist and LV ejection fraction in the overall study population. LV untwisting rate was progressively decreased in patients with AMI and HF compared with control subjects (p <0.001, analysis of variance). A moderate correlation (r = 0.56, p <0.001) was noted between peak LV untwisting rate and grade of diastolic dysfunction in the overall study population. In conclusion, LV twist and untwisting rate are strongly related to LV systolic and diastolic functions, respectively. Impairment of LV function observed in patients with AMI and HF is associated with a decrease of LV twist and untwisting rate. © 2009 Elsevier Inc. All rights reserved.
Left Ventricular Rotational Mechanics in Acute Myocardial Infarction and in Chronic (Ischemic and Nonischemic) Heart Failure Patients
Bertini M.;
2009
Abstract
Left ventricular (LV) twist and untwisting rate are emerging as global and thorough parameters for assessment of LV function. This study explored differences of LV twist and untwisting rate in patients with acute myocardial infarction (AMI) and patients with ischemic and nonischemic chronic heart failure (HF). Fifty patients with AMI, 49 with ischemic HF, and 38 with nonischemic HF were studied. As a control group, 28 subjects without evidence of structural heart disease were included. Speckle-tracking analysis was applied to LV short-axis images at basal and apical levels. LV twist was defined as the net difference of apical and basal rotations at isochronal time points. The first time derivative of LV untwist was defined as the LV untwisting rate. Compared with control subjects, peak LV twist was decreased in patients with AMI and extremely decreased in those with HF (p <0.001, analysis of variance). A strong correlation (r = 0.87, p <0.001) was found between peak LV twist and LV ejection fraction in the overall study population. LV untwisting rate was progressively decreased in patients with AMI and HF compared with control subjects (p <0.001, analysis of variance). A moderate correlation (r = 0.56, p <0.001) was noted between peak LV untwisting rate and grade of diastolic dysfunction in the overall study population. In conclusion, LV twist and untwisting rate are strongly related to LV systolic and diastolic functions, respectively. Impairment of LV function observed in patients with AMI and HF is associated with a decrease of LV twist and untwisting rate. © 2009 Elsevier Inc. All rights reserved.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
