title: Assessment of the rotation motion at the papillary muscle short-axis plane with normal subjects by two-dimensional speckle tracking imaging: a basic clinical study.
abstract: BACKGROUND
  The aim of this study was to observe the rotation patterns at the papillary muscle plane in the Left Ventricle(LV) with normal subjects using two-dimensional speckle tracking imaging(2D-STI).
  
  
  METHODS
  We acquired standard of the basal, the papillary muscle and the apical short-axis images of the LV in 64 subjects to estimate the LV rotation motion by 2D-STI. The rotational degrees at the papillary muscle short-axis plane were measured at 15 different time points in the analysis of two heart cycles.
  
  
  RESULTS
  There were counterclockwise rotation, clockwise rotation, and counterclockwise to clockwise rotation at the papillary muscle plane in the LV with normal subjects, respectively. The ROC analysis of the rotational degrees was performed at the papillary muscle short-axis plane at the peak LV torsion for predicting whether the turnaround point of twist to untwist motion pattern was located at the papillary muscle level. Sensitivity and specificity were 97% and 67%, respectively, with a cut-off value of 0.34°, and an area under the ROC curve of 0.8. At the peak LV torsion, there was no correlation between the rotational degrees at the papillary muscle short-axis plane and the LVEF in the normal subjects(r = 0.000, p = 0.998).
  
  
  CONCLUSIONS
  In the study, we conclude that there were three rotation patterns at the papillary muscle short-axis levels, and the transition from basal clockwise rotation to apical counterclockwise rotation is located at the papillary muscle level.
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xian-Da
authors.initials: XD
authors.lastname: Ni
authors.affiliation: Department of Echocardiography, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Yuan-Ping
authors.initials: YP
authors.lastname: Hu
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Henan university of TCM, Zhengzhou, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Xu
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wei-Yu
authors.initials: WY
authors.lastname: Yang
authors.affiliation: Department of Ultrasound, The second Affiliated Hospital of ZheJiang Univercity, Hangzhou, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Zhou
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000502:physiology*; D012372:ROC Curve; D012399:Rotation; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left