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Assessment of left ventricular twist mechanics by speckle tracking echocardiography reveals association between LV twist and myocardial fibrosis in patients with hypertrophic cardiomyopathy.

Zhang HJ, Wang H, Sun T, Lu MJ, Xu N, Wu WC, Sun X, Wang WG, Lin QW - Int J Cardiovasc Imaging (2014)

Bottom Line: No significant differences were found between baseline characteristics of HCM and control groups (all p > 0.05).Bas-Rotation, AP-Rotation, LV-Twist, LADs, IVST, LAVi, E/Em and LVMI were significantly higher in HCM patients with fibrosis than in those without fibrosis (p < 0.001), but no significant differences in other echocardiographic parameters were found between those with and without fibrosis.Age, Bas-Rotation, AP-Rotation, LV twist, LADs, IVST, LAVi, E/A, E/Em, and LVMI were significant effect factors for fibrosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Bei Lishi Road, Xicheng District, Beijing, 100037, People's Republic of China.

ABSTRACT
We aimed to investigate whether left ventricular (LV) twist analysis can detect the extent of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM). This prospective case-control study recruited 81 consecutive patients with HCM examined between January 2012 and April 2013. Data of 76 patients were analyzed after excluding 5 patients whose echocardiographic images were of poor quality. Healthy volunteers (n = 46) served as controls. Both groups underwent comprehensive echocardiographic examination (i.e., Bas-Rotation, AP-Rotation, LVEF, LADs, IVST, LAVi, E/Em, LVMI, advanced LV-twist analysis by speckle tracking echocardiography) and magnetic resonance imaging. Between-group differences were analyzed by independent t test; logistic regression analysis was performed to identify effect factors. No significant differences were found between baseline characteristics of HCM and control groups (all p > 0.05). HCM patients had significantly higher Bas-Rotation, AP-Rotation, LV Twist, LVEF, LADs, IVST, LAVi, E/Em and LVMI than controls (all p < 0.0001) and significantly lower LVDd and E/A (both p < 0.001). Bas-Rotation, AP-Rotation, LV-Twist, LADs, IVST, LAVi, E/Em and LVMI were significantly higher in HCM patients with fibrosis than in those without fibrosis (p < 0.001), but no significant differences in other echocardiographic parameters were found between those with and without fibrosis. Age, Bas-Rotation, AP-Rotation, LV twist, LADs, IVST, LAVi, E/A, E/Em, and LVMI were significant effect factors for fibrosis. AUROC analysis showed that LV twist had high discriminatory power to detect extent of myocardial fibrosis (AUC 0.996, 95 % CI 0.989-1.004, p < 0.001). Left ventricular twist mechanics are associated with the extent of myocardial fibrosis. LV-twist assessment by STE may be clinically useful.

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Two-dimensional speckle tracking images in the short-axis view at the mitral valve and apical level are shown. Apical rotation, basal rotation, and LV twist in HCM patients is significantly higher than in controls. HCM hypertrophic cardiomyopathy
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Fig1: Two-dimensional speckle tracking images in the short-axis view at the mitral valve and apical level are shown. Apical rotation, basal rotation, and LV twist in HCM patients is significantly higher than in controls. HCM hypertrophic cardiomyopathy

Mentions: Comparisons of echocardiography parameters between HCM and control groups are presented in Table 2. Among 122 patients, the mean Bas-Rotation was 7.4°, mean AP-Rotation was 9.9°, mean LV-Twist was 17.3°, mean LVEF was 69.2 %, mean LADs was 37.4 mm, mean LVDd was 42.3 mm, mean IVST was 16.3 mm, mean LAVi was 43.5 ml/m2, mean E/A was 1.1, mean E/Em was 12.3 and mean LVMI was 100.2 g/m2. The HCM group had significantly higher values for Bas-Rotation, AP-Rotation, LV-Twist, LVEF, LADs, LAVi, IVST, LVPWT, RWT, E/Em and LVMI than the control group (all p < 0.0001). LVDd and E/A were significantly lower in the HCM group than in the control group (both p < 0.001) (Table 2). Representative examples are shown in Fig. 1.Table 2


Assessment of left ventricular twist mechanics by speckle tracking echocardiography reveals association between LV twist and myocardial fibrosis in patients with hypertrophic cardiomyopathy.

Zhang HJ, Wang H, Sun T, Lu MJ, Xu N, Wu WC, Sun X, Wang WG, Lin QW - Int J Cardiovasc Imaging (2014)

Two-dimensional speckle tracking images in the short-axis view at the mitral valve and apical level are shown. Apical rotation, basal rotation, and LV twist in HCM patients is significantly higher than in controls. HCM hypertrophic cardiomyopathy
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4232740&req=5

Fig1: Two-dimensional speckle tracking images in the short-axis view at the mitral valve and apical level are shown. Apical rotation, basal rotation, and LV twist in HCM patients is significantly higher than in controls. HCM hypertrophic cardiomyopathy
Mentions: Comparisons of echocardiography parameters between HCM and control groups are presented in Table 2. Among 122 patients, the mean Bas-Rotation was 7.4°, mean AP-Rotation was 9.9°, mean LV-Twist was 17.3°, mean LVEF was 69.2 %, mean LADs was 37.4 mm, mean LVDd was 42.3 mm, mean IVST was 16.3 mm, mean LAVi was 43.5 ml/m2, mean E/A was 1.1, mean E/Em was 12.3 and mean LVMI was 100.2 g/m2. The HCM group had significantly higher values for Bas-Rotation, AP-Rotation, LV-Twist, LVEF, LADs, LAVi, IVST, LVPWT, RWT, E/Em and LVMI than the control group (all p < 0.0001). LVDd and E/A were significantly lower in the HCM group than in the control group (both p < 0.001) (Table 2). Representative examples are shown in Fig. 1.Table 2

Bottom Line: No significant differences were found between baseline characteristics of HCM and control groups (all p > 0.05).Bas-Rotation, AP-Rotation, LV-Twist, LADs, IVST, LAVi, E/Em and LVMI were significantly higher in HCM patients with fibrosis than in those without fibrosis (p < 0.001), but no significant differences in other echocardiographic parameters were found between those with and without fibrosis.Age, Bas-Rotation, AP-Rotation, LV twist, LADs, IVST, LAVi, E/A, E/Em, and LVMI were significant effect factors for fibrosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Bei Lishi Road, Xicheng District, Beijing, 100037, People's Republic of China.

ABSTRACT
We aimed to investigate whether left ventricular (LV) twist analysis can detect the extent of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM). This prospective case-control study recruited 81 consecutive patients with HCM examined between January 2012 and April 2013. Data of 76 patients were analyzed after excluding 5 patients whose echocardiographic images were of poor quality. Healthy volunteers (n = 46) served as controls. Both groups underwent comprehensive echocardiographic examination (i.e., Bas-Rotation, AP-Rotation, LVEF, LADs, IVST, LAVi, E/Em, LVMI, advanced LV-twist analysis by speckle tracking echocardiography) and magnetic resonance imaging. Between-group differences were analyzed by independent t test; logistic regression analysis was performed to identify effect factors. No significant differences were found between baseline characteristics of HCM and control groups (all p > 0.05). HCM patients had significantly higher Bas-Rotation, AP-Rotation, LV Twist, LVEF, LADs, IVST, LAVi, E/Em and LVMI than controls (all p < 0.0001) and significantly lower LVDd and E/A (both p < 0.001). Bas-Rotation, AP-Rotation, LV-Twist, LADs, IVST, LAVi, E/Em and LVMI were significantly higher in HCM patients with fibrosis than in those without fibrosis (p < 0.001), but no significant differences in other echocardiographic parameters were found between those with and without fibrosis. Age, Bas-Rotation, AP-Rotation, LV twist, LADs, IVST, LAVi, E/A, E/Em, and LVMI were significant effect factors for fibrosis. AUROC analysis showed that LV twist had high discriminatory power to detect extent of myocardial fibrosis (AUC 0.996, 95 % CI 0.989-1.004, p < 0.001). Left ventricular twist mechanics are associated with the extent of myocardial fibrosis. LV-twist assessment by STE may be clinically useful.

Show MeSH
Related in: MedlinePlus