title: Evaluation of left ventricular torsion in children with hypertrophic cardiomyopathy.
abstract: OBJECTIVE
  To evaluate the role of torsion in hypertrophic cardiomyopathy in children.
  
  
  METHODS
  A total of 88 children with idiopathic hypertrophic cardiomyopathy (n = 24) and concentric hypertrophy (n = 20) were investigated with speckle-tracking echocardiography and compared with age- and gender-matched healthy controls (n = 44).
  
  
  RESULTS
  In hypertrophic cardiomyopathy, we found increased torsion (2.8 ± 1.6 versus 1.9 ± 1.0°/cm [controls], p < 0.05) because of an increase in clockwise basal rotation (-8.7 ± 4.3° versus -4.9 ± 2.5° [controls], p < 0.001) and prolonged time to peak diastolic untwisting (3.7 ± 2.4% versus 1.7 ± 0.6% [controls] of cardiac cycle, p < 0.01), but no differences in peak untwisting velocities. Hypertrophic cardiomyopathy patients demonstrated a negative correlation between left ventricular muscle mass and torsion (r = -0.7, p < 0.001). In concentric hypertrophy, torsion was elevated because of increased apical rotation (15.1 ± 6.4° versus 10.5 ± 5.5° [controls], p < 0.05) without correlation with muscle mass. Peak untwisting velocities (- 202 ± 88 versus -145 ± 67°/s [controls], p < 0.05) were higher in concentric hypertrophy and time to peak diastolic untwisting was delayed (1.8 ± 0.8% versus 1.2 ± 0.6% [controls], p < 0.05).
  
  
  CONCLUSIONS
  In contrast to an increased counterclockwise apical rotation in concentric hypertrophy, hypertrophic cardiomyopathy is characterised by predominantly enhanced systolic basal clockwise rotation. Diastolic untwisting is delayed in both groups. Torsion may be an interesting marker to guide patients with hypertrophic cardiomyopathy.
authors: 1 Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Christian
authors: C
authors: Prinz
authors: 1 Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Lothar
authors: L
authors: Faber
authors: 1 Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Dieter
authors: D
authors: Horstkotte
authors: 2 Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Hermann
authors: H
authors: Körperich
authors: 2 Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Axel
authors: A
authors: Moysich
authors: 2 Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Nikolaus
authors: N
authors: Haas
authors: 2 Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Deniz
authors: D
authors: Kececioglu
authors: 2 Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
authors: Kai
authors: K
authors: Thorsten Laser
mesh_terms: D000293:Adolescent; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D008297:Male; D011446:Prospective Studies; D014102:Torsion Abnormality / Q000000981:diagnostic imaging*; D055815:Young Adult