title: Changes in left ventricular twist after mitral valve repair.
abstract: OBJECTIVE
  We performed echocardiographic tissue tracking to investigate whether mitral valve repair preserves left ventricular function.
  
  
  METHODS
  We studied 16 subjects without heart disease (11 male; mean age, 54.6 ± 15.1 years) and 18 patients in normal sinus rhythm undergoing solitary mitral valve repair (12 male; mean age, 53.6 ± 16.6 years). Transthoracic echocardiography was performed before and after surgery, and left ventricular apical and basal short-axis images were recorded. Left ventricular rotation angle was measured with off-line Vector Velocity Imaging (Siemens Medical Solutions USA Inc, Mountain View, Calif) at each slice level.
  
  
  RESULTS
  Left ventricular ejection fraction was significantly higher in the control (68.4% ± 3.6%) and preoperative groups (70.9% ± 6.5%) than the postoperative group (59.4% ± 11.4%, P < .05). Left ventricular end-diastolic and end-systolic volumes were significantly greater in the preoperative group than the control group (130.0 ± 41.5 mL and 41.6 ± 16.6 mL vs 80.0 ± 16.7 mL and 26.6 ± 9.2 mL, respectively, P < .05). Left ventricular end-diastolic volume normalized postoperatively. Left ventricular twist was significantly greater in the preoperative group than the other groups (11.7° ± 4.1° versus 7.1° ± 3.8° and 8.2° ± 5.7°, P < .05). Left ventricular twist did not differ significantly between control and postoperative groups. New York Heart Association functional class improved from 1.6 ± 0.5 to 1.0 ± 0.0 after surgery (P < .05).
  
  
  CONCLUSIONS
  Although preoperative left ventricular ejection fraction seemed normal, left ventricular twist was greater. Left ventricular twist normalized after surgery, suggesting that it preserves left ventricular function.
authors.affiliation: Heart Center, Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan. t-kazui@pf6.so-net.ne.jp
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Kazui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Niinuma
authors.forename: Junichi
authors.initials: J
authors.lastname: Tsuboi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okabayashi
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D013318:Stroke Volume; D054159:Torsion, Mechanical; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left