title: Left ventricular rotational mechanics in acute myocardial infarction and in chronic (ischemic and nonischemic) heart failure patients.
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.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
authors.forename: Gaetano
authors.initials: G
authors.lastname: Nucifora
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: van Bommel
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.forename: Eduard R
authors.initials: ER
authors.lastname: Holman
authors.forename: Ernst E
authors.initials: EE
authors.lastname: Van der Wall
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D012399:Rotation; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left / Q000502:physiology