The impact of isometric handgrip testing on left ventricular twist mechanics

被引:43
作者
Weiner, Rory B. [1 ]
Weyman, Arthur E. [1 ]
Kim, Jonathan H. [1 ]
Wang, Thomas J. [1 ]
Picard, Michael H. [1 ]
Baggish, Aaron L. [1 ]
机构
[1] Massachusetts Gen Hosp, Cardiovasc Performance Program, Div Cardiol, Boston, MA 02114 USA
来源
JOURNAL OF PHYSIOLOGY-LONDON | 2012年 / 590卷 / 20期
关键词
SPECKLE TRACKING ECHOCARDIOGRAPHY; INOTROPIC STIMULATION; MYOCARDIAL-INFARCTION; APICAL ROTATION; HEART-RATE; TORSION; HUMANS; PRESSURE; EXERCISE; PRELOAD;
D O I
10.1113/jphysiol.2012.236166
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Key points Left ventricular twist (LVT) results from rotation of the LV apex and base in opposite directions. Although LVT is altered in various cardiac diseases, physiological factors that affect LVT remain incompletely understood. In an experimental model involving healthy humans, isometric handgrip testing (IHGT) was performed to produce a clinically relevant form of LV afterload increase. The impact of IHGT on LV twist mechanics was assessed using speckle-tracking echocardiography. IHGT produced significant increase in systemic blood pressure and acute reduction in LV stroke volume. In this setting, LV apical rotation and LVT significantly decreased. Impairment of LV twist mechanics may in part underlie the LV dysfunction that can occur in the clinical context of acute increase in afterload. Abstract Left ventricular (LV) rotation occurs due to contraction of obliquely oriented myocardial fibres. Left ventricular twist (LVT) results from rotation of the apex and base in opposite directions. Although LVT is altered in various cardiac diseases, physiological factors that affect LVT remain incompletely understood. Isometric handgrip testing (IHGT), a well-established laboratory-based technique to increase LV afterload, was performed for 3 min at 40% maximum force generation in healthy human subjects (n= 18, mean age 29.7 +/- 2.7 years). Speckle-tracking echocardiography was used to measure LV volumes, LV apical and basal rotation, peak systolic LVT and peak early diastolic untwisting rate (UTR) at rest and at peak IHGT. IHGT led to significant increase in systemic blood pressure (systolic, 120.6 +/- 9.7 vs. 155.6 +/- 14.5 mmHg, P < 0.001; diastolic, 67.5 +/- 6.4 vs. 94.1 +/- 21.1 mmHg, P < 0.001) and LV end-systolic volume (44.2 +/- 7.8 vs. 50.5 +/- 10.8 ml, P= 0.005), as well as a significant increase in heart rate (62.8 +/- 11.7 vs. 84.7 +/- 13.8 beats min-1; P < 0.001). IHGT produced a significant acute reduction in LV stroke volume (63.9 +/- 12.0 vs. 49.4 +/- 7.8 ml, P < 0.001). In this setting, there was a significant decrease in peak systolic apical rotation (11.9 +/- 3.0 vs. 8.6 +/- 2.2 deg, P < 0.001) and a resultant 25% decrease in peak systolic LVT (16.6 +/- 2.8 vs. 12.5 +/- 2.8 deg, P < 0.001). The magnitude of peak early diastolic UTR did not change (-114.5 +/- 26.4 vs. -110.6 +/- 39.8 deg s-1, P= 0.71). Peak systolic apical rotation and LVT decrease during IHGT in healthy humans. This impairment of LV twist mechanics may in part underlie the LV dysfunction that can occur in the clinical context of acute increase in afterload.
引用
收藏
页码:5141 / 5150
页数:10
相关论文
共 35 条
[1]   DEPENDENCE OF LEFT-VENTRICULAR TWIST-RADIAL SHORTENING RELATIONS ON CARDIAC CYCLE PHASE [J].
BEYAR, R ;
YIN, FCP ;
HAUSKNECHT, M ;
WEISFELDT, ML ;
KASS, DA .
AMERICAN JOURNAL OF PHYSIOLOGY, 1989, 257 (04) :H1119-H1126
[2]   Independent effects of preload, afterload, and contractility on left ventricular torsion [J].
Dong, SJ ;
Hees, PS ;
Huang, WM ;
Buffer, SA ;
Weiss, JL ;
Shapiro, EP .
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, 1999, 277 (03) :H1053-H1060
[3]   Cardiovascular and sympathetic neural responses to handgrip and cold pressor stimuli in humans before, during and after spaceflight [J].
Fu, Q ;
Levine, BD ;
Pawelczyk, JA ;
Ertl, AC ;
Diedrich, A ;
Cox, JF ;
Zuckerman, JH ;
Ray, CA ;
Smith, ML ;
Iwase, S ;
Saito, M ;
Sugiyama, Y ;
Mano, T ;
Zhang, R ;
Iwasaki, K ;
Lane, LD ;
Buckey, JC ;
Cooke, WH ;
Robertson, RM ;
Baisch, FJ ;
Blomqvist, CG ;
Eckberg, DL ;
Robertson, D ;
Biaggioni, I .
JOURNAL OF PHYSIOLOGY-LONDON, 2002, 544 (02) :653-664
[4]   VARIATION IN ISOMETRIC TENSION WITH SARCOMERE LENGTH IN VERTEBRATE MUSCLE FIBRES [J].
GORDON, AM ;
HUXLEY, AF ;
JULIAN, FJ .
JOURNAL OF PHYSIOLOGY-LONDON, 1966, 184 (01) :170-+
[5]   EFFECT OF VOLUME LOADING, PRESSURE LOADING, AND INOTROPIC STIMULATION ON LEFT-VENTRICULAR TORSION IN HUMANS [J].
HANSEN, DE ;
DAUGHTERS, GT ;
ALDERMAN, EL ;
INGELS, NB ;
STINSON, EB ;
MILLER, DC .
CIRCULATION, 1991, 83 (04) :1315-1326
[6]   EVALUATION OF PRELOAD RESERVE DURING ISOMETRIC-EXERCISE TESTING IN PATIENTS WITH OLD MYOCARDIAL-INFARCTION - DOPPLER ECHOCARDIOGRAPHIC STUDY [J].
HAYASHI, K ;
DOTE, K ;
SUNAGA, Y ;
SUGIURA, T ;
IWASAKA, T ;
INADA, M .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 17 (01) :106-111
[7]   New noninvasive method for assessment of left ventricular rotation - Speckle tracking echocardiography [J].
Helle-Valle, T ;
Crosby, J ;
Edvardsen, T ;
Lyseggen, E ;
Amundsen, BH ;
Smith, HJ ;
Rosen, BD ;
Lima, JAC ;
Torp, H ;
Ihlen, H ;
Smiseth, OA .
CIRCULATION, 2005, 112 (20) :3149-3156
[8]   EFFECTS OF LOAD MANIPULATIONS, HEART-RATE, AND CONTRACTILITY ON LEFT-VENTRICULAR APICAL ROTATION - AN EXPERIMENTAL-STUDY IN ANESTHETIZED DOGS [J].
KROEKER, CAG ;
TYBERG, JV ;
BEYAR, R .
CIRCULATION, 1995, 92 (01) :130-141
[9]   Recommendations for chamber quantification: A report from the American Society of Echocardiography's guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology [J].
Lang, RM ;
Bierig, M ;
Devereux, RB ;
Flachskampf, FA ;
Foster, E ;
Pellikka, PA ;
Picard, MH ;
Roman, MJ ;
Seward, J ;
Shanewise, JS ;
Solomon, SD ;
Spencer, KT ;
Sutton, MS ;
Stewart, WJ .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2005, 18 (12) :1440-1463
[10]   Is Torsion a Suitable Echocardiographic Parameter to Detect Acute Changes in Left Ventricular Afterload in Children? [J].
Laser, Kai Thorsten ;
Haas, Nikolaus Alexander ;
Jansen, Nadine ;
Schaeffler, Rainer ;
Argueta, Jorge Roberto Palacios ;
Zittermann, Armin ;
Peters, Brigitte ;
Koerperich, Hermann .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2009, 22 (10) :1121-1128