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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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Related in: MedlinePlus

Images are shown for an HCM patient with large LGE (a) and a patient without LGE (b). LV twist in the patient with LGE(c) was higher than that in the patient without LGE (d). HCM hypertrophic cardiomyopathy, LGE late gadolinium enhancement, LV left ventricular
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Fig2: Images are shown for an HCM patient with large LGE (a) and a patient without LGE (b). LV twist in the patient with LGE(c) was higher than that in the patient without LGE (d). HCM hypertrophic cardiomyopathy, LGE late gadolinium enhancement, LV left ventricular

Mentions: The distribution of characteristics in HCM patients with and without fibrosis is presented in Table 3. In the 76 HCM patients, means for Bas-Rotation, AP-Rotation, LV-Twist, LADs, LAVi, IVST, LVPWT, RWT, E/Em, and LVMI were all significantly higher in the fibrosis group than in the non-fibrosis group (p < 0.001). Means of age and E/A were significantly lower in the fibrosis group compared with non-fibrosis group (age: 44.6 vs. 51.7 years, p = 0.007; E/A: 1.0 vs. 1.2, p = 0.001). No significant differences were found between non-fibrosis vs. fibrosis groups in heart rate, BSA, BMI, SBP, DBP and LVEF (p > 0.05). Representative examples are shown in Fig. 2.Table 3


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)

Images are shown for an HCM patient with large LGE (a) and a patient without LGE (b). LV twist in the patient with LGE(c) was higher than that in the patient without LGE (d). HCM hypertrophic cardiomyopathy, LGE late gadolinium enhancement, LV left ventricular
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Images are shown for an HCM patient with large LGE (a) and a patient without LGE (b). LV twist in the patient with LGE(c) was higher than that in the patient without LGE (d). HCM hypertrophic cardiomyopathy, LGE late gadolinium enhancement, LV left ventricular
Mentions: The distribution of characteristics in HCM patients with and without fibrosis is presented in Table 3. In the 76 HCM patients, means for Bas-Rotation, AP-Rotation, LV-Twist, LADs, LAVi, IVST, LVPWT, RWT, E/Em, and LVMI were all significantly higher in the fibrosis group than in the non-fibrosis group (p < 0.001). Means of age and E/A were significantly lower in the fibrosis group compared with non-fibrosis group (age: 44.6 vs. 51.7 years, p = 0.007; E/A: 1.0 vs. 1.2, p = 0.001). No significant differences were found between non-fibrosis vs. fibrosis groups in heart rate, BSA, BMI, SBP, DBP and LVEF (p > 0.05). Representative examples are shown in Fig. 2.Table 3

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