Left ventricular twist in clinically stable heart transplantation recipients: A speckle tracking echocardiography study

Background and aim: Cavity twist is an integral part of LV function and its pattern in transplanted hearts is not well known. This study aimed at exploring LV twist in clinically stable heart transplant (HT) recipients with no evidence for rejection. Methods: We studied 32 HT patients (54 +/- 24 months after HT), 34 other cardiac surgery (CS) patients and compared them with 35 health controls using speckle tracking echocardiography, measuring peak twist angle, time-to-peak twist, and untwist rate. Results: LV twist angle was smaller in the HT group (6.2 +/- 3.3 degrees) in comparison with the CS group and controls (13.2 +/- 3.5 degrees and 13.1 +/- 4.5 degrees, respectively; p<0.0001 for all) and untwist rate was reduced (HT group: -74 +/- 30 degrees/s; CS group: -118 +/- 43 degrees/s; controls:- 116 +/- 39 degrees/s; p<0.0001 for all). Time-to-peak twist was not different between groups. Time after HT was the main independent predictor of both LV twist angle and untwist rate (beta=0.8, p<0.0001). Conclusion: Though clinically stable, LV twist dynamics are significantly impaired in HT recipients, even in comparison with patients who underwent other cardiac surgery. (c) 2012 Elsevier Ireland Ltd. All rights reserved.