title: Left ventricular twist mechanics in the context of normal physiology and cardiovascular disease: a review of studies using speckle tracking echocardiography.
abstract: The anatomy of the adult human left ventricle (LV) is the result of its complex interaction with its environment. From the fetal to the neonatal to the adult form, the human LV undergoes an anatomical transformation that finally results in the most complex of the four cardiac chambers. In its adult form, the human LV consists of two muscular helixes that surround the midventricular circumferential layer of muscle fibers. Contraction of these endocardial and epicardial helixes results in a twisting motion that is thought to minimize the transmural stress of the LV muscle. In the healthy myocardium, the LV twist response to stimuli that alter preload, afterload, or contractility has been described and is deemed relatively consistent and predictable. Conversely, the LV twist response in patient populations appears to be a little more variable and less predictable, yet it has revealed important insight into the effect of cardiovascular disease on LV mechanical function. This review discusses important methodological aspects of assessing LV twist and evaluates the LV twist responses to the main physiological and pathophysiological states. It is concluded that correct assessment of LV twist mechanics holds significant potential to advance our understanding of LV function in human health and cardiovascular disease.
authors.affiliation: Discipline of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom; and estohr@cardiffmet.ac.uk.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Stöhr
authors.affiliation: Discipline of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom; and.
authors.forename: Rob E
authors.initials: RE
authors.lastname: Shave
authors.affiliation: Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Baggish
authors.affiliation: Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Rory B
authors.initials: RB
authors.lastname: Weiner
mesh_terms: D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D004699:Endocardium / Q000000981:diagnostic imaging* / Q000502:physiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000502:physiology / Q000503:physiopathology; D012399:Rotation; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: cardiovascular disease; deformation; exercise; torsion; twist