TY - JOUR
T1 - Left ventricular twist and untwist in aortic stenosis
AU - Van Dalen, Bas M.
AU - Tzikas, Apostolos
AU - Soliman, Osama I.I.
AU - Kauer, Floris
AU - Heuvelman, Helena J.
AU - Vletter, Wim B.
AU - Ten Cate, Folkert J.
AU - Geleijnse, Marcel L.
PY - 2011/5/5
Y1 - 2011/5/5
N2 - Background: To optimally exploit the potential added diagnostic and prognostic value of new left ventricular (LV) deformation parameters, better understanding of LV mechanics in aortic stenosis (AS) is warranted. We sought to determine a broad spectrum of LV rotation parameters in AS patients and age-matched healthy controls, in order to gain insight into the mechanical properties of the LV in AS. Methods: The study comprised 48 AS patients with an aortic valve area < 2.0 cm 2 and LV ejection fraction > 50%, and 24 healthy - for age and gender matched - control subjects. LV peak systolic rotation (Rot max), LV peak systolic twist (Twist max), untwisting rate (mean diastolic untwisting velocity from Twist max to mitral valve opening), peak diastolic untwisting velocity, and time-to-peak diastolic untwisting velocity were determined by speckle tracking echocardiography. Results: AS patients had normal basal Rot max and increased apical Rot max, resulting in increased Twist max (13.4 ± 4.0° vs. 11.4 ± 2.7°, P < 0.05). Apical Rot max and Twist max correlated significantly to echo-Doppler indicators of AS severity. Time-to-peak diastolic untwisting velocity was increased (20 ± 10 % vs. 15 ± 9 %, P < 0.05) and untwisting rate was decreased (-38 ± 21°/s vs. -50 ± 28°/s, P < 0.01) in AS patients. Conclusions: Twist max increases proportionally to the severity of AS, which might serve as a compensatory mechanism to maintain systolic LV function. LV diastolic untwisting is delayed and the untwisting rate is reduced in AS.
AB - Background: To optimally exploit the potential added diagnostic and prognostic value of new left ventricular (LV) deformation parameters, better understanding of LV mechanics in aortic stenosis (AS) is warranted. We sought to determine a broad spectrum of LV rotation parameters in AS patients and age-matched healthy controls, in order to gain insight into the mechanical properties of the LV in AS. Methods: The study comprised 48 AS patients with an aortic valve area < 2.0 cm 2 and LV ejection fraction > 50%, and 24 healthy - for age and gender matched - control subjects. LV peak systolic rotation (Rot max), LV peak systolic twist (Twist max), untwisting rate (mean diastolic untwisting velocity from Twist max to mitral valve opening), peak diastolic untwisting velocity, and time-to-peak diastolic untwisting velocity were determined by speckle tracking echocardiography. Results: AS patients had normal basal Rot max and increased apical Rot max, resulting in increased Twist max (13.4 ± 4.0° vs. 11.4 ± 2.7°, P < 0.05). Apical Rot max and Twist max correlated significantly to echo-Doppler indicators of AS severity. Time-to-peak diastolic untwisting velocity was increased (20 ± 10 % vs. 15 ± 9 %, P < 0.05) and untwisting rate was decreased (-38 ± 21°/s vs. -50 ± 28°/s, P < 0.01) in AS patients. Conclusions: Twist max increases proportionally to the severity of AS, which might serve as a compensatory mechanism to maintain systolic LV function. LV diastolic untwisting is delayed and the untwisting rate is reduced in AS.
KW - Aortic stenosis
KW - Echocardiography
KW - Left ventricular mechanics
KW - Pathophysiology
UR - http://www.scopus.com/inward/record.url?scp=79955027324&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2009.11.022
DO - 10.1016/j.ijcard.2009.11.022
M3 - Article
SN - 0167-5273
VL - 148
SP - 319
EP - 324
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -
