Assessment of left ventricular twist mechanics by two-dimensional strain in severe aortic stenosis with preserved ejection fraction

被引:8
作者
Meimoun, P. [1 ]
Elmkies, F. [1 ]
Benali, T. [1 ]
Boulanger, J. [1 ]
Zemir, H. [1 ]
Clerc, J. [1 ]
Luycx-Bore, A. [1 ]
机构
[1] Ctr Hosp Compiegne, Serv Cardiol USIC, F-60200 Compiegne, France
来源
ANNALES DE CARDIOLOGIE ET D ANGEIOLOGIE | 2011年 / 60卷 / 05期
关键词
Twist; Aortic stenosis; Rotation; Left ventricle; Diastolic dysfunction; Global longitudinal strain; TORSION; RECOMMENDATIONS; ROTATION; ECHOCARDIOGRAPHY; RELAXATION; SOCIETY;
D O I
10.1016/j.ancard.2011.08.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Left ventricular (LV) twist is increased in aortic stenosis (AS) and the hypothesis of a compensatory mechanism is suggested but not established. Our aim was to assess LV twist mechanics in severe AS (< 1 cm(2) or 0.6 cm(2)/m(2)) with preserved LV ejection fraction (LVEF > 50%), and to analyze its relationship with LV systolic longitudinal function, early impaired in this setting, LV diastolic function, and symptomatic status. Methods. - Forty-five consecutive patients with severe AS and preserved LVEF (mean age 73 +/- 11 years, 47% female, LVEF 68 +/- 11%, 67% symptomatic) underwent a transthoracic echocardiography including a bidimensional strain analysis by speckle tracking method, and were compared to a control group matched for age and sex (n = 15). Global longitudinal strain (GLS) was measured using the four, two, and three apical views, and LV twist mechanics from the basal and apical short axis views. LV twist was defined as the net difference between apical and basal rotation, and LV twisting and untwisting rate (in degrees/s) were derived from twist curves. Results. - Peak apical rotation, LV twist (25 +/- 8 degrees vs 20 +/- 6), as well as peak systolic and diastolic apical rotation rate, and peak LV twisting rate were significantly higher in patients with AS when compared to controls (all, P < 0.05), whereas, the other parameters of LV twist mechanics including basal rotation, were not significantly different between groups. By contrast, the GLS was significantly lower in patients with AS when compared to controls (-17.9 +/- 4 vs 20.5 +/- 2%, P < 0.01). In addition, the GLS was significantly correlated to LV torsion (r = -0.42, P < 0.01). Moreover, LV twist progressively impaired with the worsening of diastolic dysfunction and with symptoms onset. Conclusion. - LV twist is increased in severe AS with preserved LVEF, compensating the impairment of systolic longitudinal function. However, above a certain threshold LV twist deteriorates, attesting the failure of the compensatory mechanisms, leading to advanced diastolic dysfunction and symptom onset. (C) 2011 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:259 / 266
页数:8
相关论文
共 28 条
  • [1] Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice
    Baumgartner, Helmut
    Hung, Judy
    Bermejo, Javier
    Chambers, John B.
    Evangelista, Arturo
    Griffin, Brian P.
    Iung, Bernard
    Otto, Catherine M.
    Pellikka, Patricia A.
    Quinones, Miguel
    [J]. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY, 2009, 10 (01): : 1 - 25
  • [2] Biederman RWW, 2005, CIRCULATION, V112, pI429, DOI 10.1161/CIRCULATIONAHA.104.525501
  • [3] A Unifying Framework for Understanding Heart Failure? Response to "Left Ventricular Torsion by Two-Dimensional Speckle Tracking Echocardiography in Patients With Diastolic Dysfunction and Normal Ejection Fraction" by Park SJ et al.
    Borg, Alexander N.
    Ray, Simon G.
    [J]. JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2009, 22 (03) : 318 - 320
  • [4] Increase in left ventricular torsion-to-shortening ratio in children with valvular aortic stenosis
    Delhaas, T
    Kotte, J
    van der Toorn, A
    Snoep, G
    Prinzen, FW
    Arts, T
    [J]. MAGNETIC RESONANCE IN MEDICINE, 2004, 51 (01) : 135 - 139
  • [5] Left ventricular torsion and recoil: implications for exercise performance and cardiovascular disease
    Esch, Ben T.
    Warburton, Darren E. R.
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 2009, 106 (02) : 362 - 369
  • [6] New noninvasive method for assessment of left ventricular rotation - Speckle tracking echocardiography
    Helle-Valle, T
    Crosby, J
    Edvardsen, T
    Lyseggen, E
    Amundsen, BH
    Smith, HJ
    Rosen, BD
    Lima, JAC
    Torp, H
    Ihlen, H
    Smiseth, OA
    [J]. CIRCULATION, 2005, 112 (20) : 3149 - 3156
  • [7] 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
    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
    [J]. JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2005, 18 (12) : 1440 - 1463
  • [8] Aortic valve replacement normalizes left ventricular twist function
    Lindqvist, Per
    Zhao, Ying
    Bajraktari, Gani
    Holmgren, Anders
    Henein, Michael Y.
    [J]. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2011, 12 (05) : 701 - 706
  • [9] Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications Endorsed by the Japanese Society of Echocardiography
    Mor-Avi, Victor
    Lang, Roberto M.
    Badano, Luigi P.
    Belohlavek, Marek
    Cardim, Nuno Miguel
    Derumeaux, Genevieve
    Galderisi, Maurizio
    Marwick, Thomas
    Nagueh, Sherif F.
    Sengupta, Partho P.
    Sicari, Rosa
    Smiseth, Otto A.
    Smulevitz, Beverly
    Takeuchi, Masaaki
    Thomas, James D.
    Vannan, Mani
    Voigt, Jens-Uwe
    Zamorano, Jose Luis
    [J]. JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2011, 24 (03) : 277 - 313
  • [10] Cardiac rotation and relaxation in patients with aortic valve stenosis
    Nagel, E
    Stuber, M
    Burkhard, B
    Fischer, SE
    Scheidegger, MB
    Boesiger, P
    Hess, OM
    [J]. EUROPEAN HEART JOURNAL, 2000, 21 (07) : 582 - 589