TY - JOUR
T1 - Regional left ventricular rotation and back-rotation in patients with reverse septal curvature hypertrophic cardiomyopathy
AU - Kauer, Floris
AU - Van Dalen, Bas M.
AU - Soliman, Osama I.I.
AU - Van Der Zwaan, Heleen B.
AU - Vletter, Wim B.
AU - Schinkel, Arend F.L.
AU - Ten Cate, Folkert J.
AU - Geleijnse, Marcel L.
PY - 2013/5
Y1 - 2013/5
N2 - AimsThis study sought to investigate regional left ventricular (LV) rotation in patients with hypertrophic cardiomyopathy (HCM).Methods and resultsThe study comprised 44 patients with HCM with a typical reverse septal curvature (age 40 ± 14 years, 33 men) and 44 healthy volunteers (age 39 ± 14 years, 32 men) in whom LV rotation could be assessed at the basal and apical LV level with speckle-tracking echocardiography, using the QLAB Advanced Quantification Software version 6.0 (Philips, Best, The Netherlands). In HCM patients, lower values of initial counter-clockwise rotation at the basal LV level (1.5 ± 1.2 vs. 0.6 ± 0.9°, P < 0.001) were seen, in particular in the septal segment (1.7 ± 1.6 vs. 0.4 ± 0.7°, P < 0.001). After this period, the direction of rotation changed to clockwise with a peak basal rotation of -4.8 ± 2.0° in controls vs. -6.1 ± 2.5° in HCM patients (P < 0.05). Peak basal rotation in HCM patients was in particular higher in the anterior (-6.6 ± 3.0 vs. -4.4 ± 2.4°, P < 0.01) and septal (-5.4 ± 2.6 vs. -3.9 ± 1.9°, P < 0.05) segments. The normalized (corrected for peak basal rotation) global back-rotation rate was lower in HCM patients (4.1 ± 3.1 vs. 6.3 ± 4.9 s-1, P < 0.05), in particular driven by a lower rate in the septal segment (3.8 ± 2.6 vs. 6.4 ± 4.8 s -1, P < 0.01). At the apical level, changes in rotation and back-rotation were more homogeneous.ConclusionChanges in rotation and back-rotation at the LV basal level in HCM patients are mainly caused by regional changes in the basal septal and anterior segments, the segments mostly involved in the hypertrophic process.
AB - AimsThis study sought to investigate regional left ventricular (LV) rotation in patients with hypertrophic cardiomyopathy (HCM).Methods and resultsThe study comprised 44 patients with HCM with a typical reverse septal curvature (age 40 ± 14 years, 33 men) and 44 healthy volunteers (age 39 ± 14 years, 32 men) in whom LV rotation could be assessed at the basal and apical LV level with speckle-tracking echocardiography, using the QLAB Advanced Quantification Software version 6.0 (Philips, Best, The Netherlands). In HCM patients, lower values of initial counter-clockwise rotation at the basal LV level (1.5 ± 1.2 vs. 0.6 ± 0.9°, P < 0.001) were seen, in particular in the septal segment (1.7 ± 1.6 vs. 0.4 ± 0.7°, P < 0.001). After this period, the direction of rotation changed to clockwise with a peak basal rotation of -4.8 ± 2.0° in controls vs. -6.1 ± 2.5° in HCM patients (P < 0.05). Peak basal rotation in HCM patients was in particular higher in the anterior (-6.6 ± 3.0 vs. -4.4 ± 2.4°, P < 0.01) and septal (-5.4 ± 2.6 vs. -3.9 ± 1.9°, P < 0.05) segments. The normalized (corrected for peak basal rotation) global back-rotation rate was lower in HCM patients (4.1 ± 3.1 vs. 6.3 ± 4.9 s-1, P < 0.05), in particular driven by a lower rate in the septal segment (3.8 ± 2.6 vs. 6.4 ± 4.8 s -1, P < 0.01). At the apical level, changes in rotation and back-rotation were more homogeneous.ConclusionChanges in rotation and back-rotation at the LV basal level in HCM patients are mainly caused by regional changes in the basal septal and anterior segments, the segments mostly involved in the hypertrophic process.
KW - Hypertrophic cardiomyopathy
KW - Left ventricular rotation
KW - Regional left ventricular function
KW - Speckle-tracking echocardiography
UR - http://www.scopus.com/inward/record.url?scp=84876561289&partnerID=8YFLogxK
U2 - 10.1093/ehjci/jes163
DO - 10.1093/ehjci/jes163
M3 - Article
SN - 2047-2404
VL - 14
SP - 435
EP - 442
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
IS - 5
ER -