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Left Ventricular Rigid Body Rotation in Ebstein's Anomaly from the MAGYAR-Path Study.

Nemes A, Havasi K, Domsik P, Kalapos A, Forster T - Arq. Bras. Cardiol. (2016)

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary.

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A 70-year-old female patient with Ebstein's anomaly (EA) that had never undergone During 2D echocardiography, the septal leaflet-tricuspid annulus distance showed to be 25 mm, confirming EA... However, all LV regions moved in almost the same counterclockwise direction, confirming absence of LV defect in which septal and posterior leaflets of the tricuspid valve are displaced towards the RV apex, leading to RV partial atrialization, although the anatomic annulus known feature in LV myocardial mechanics, in a single patient with unrepaired EA... LV-RBR could be partially explained by the impaired ventricle-to-ventricle interactions due to displaced tricuspid valve leaflet attachments, alterations in the anatomic myocardial fiber orientation, but other reasons could also not be excluded.

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Related in: MedlinePlus

Apical 4-chamber (A) and 2-chamber (B) views and short–axis views (C3, C5,C7) at different levels of the left ventricle (LV) extracted from thethree-dimensional (3D) echocardiographic dataset are shown in the patientwith Ebstein’s anomaly. The 3D image of the LV and calculated LV volumetricand functional characteristics (EDV: end-diastolic volume; ESV: end-systolicvolume; EF: ejection fraction) are also demonstrated together with LV apical(white arrow), mid-ventricular and basal (dashed arrow) rotations in thesame counterclockwise direction, confirming absence of the LV twist, called“rigid body rotation”.
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f1: Apical 4-chamber (A) and 2-chamber (B) views and short–axis views (C3, C5,C7) at different levels of the left ventricle (LV) extracted from thethree-dimensional (3D) echocardiographic dataset are shown in the patientwith Ebstein’s anomaly. The 3D image of the LV and calculated LV volumetricand functional characteristics (EDV: end-diastolic volume; ESV: end-systolicvolume; EF: ejection fraction) are also demonstrated together with LV apical(white arrow), mid-ventricular and basal (dashed arrow) rotations in thesame counterclockwise direction, confirming absence of the LV twist, called“rigid body rotation”.

Mentions: A 70-year-old female patient with Ebstein's anomaly (EA) that had never undergonepalliation was assessed (the case originates from the MAGYAR-Path Study). Completetwo-dimensional (2D) Doppler and three-dimensional (3D) speckle-trackingechocardiography were carried out with commercially available Toshiba Artida™echocardiography equipment. During 2D echocardiography, the septal leaflet-tricuspidannulus distance showed to be 25 mm, confirming EA. While the right ventricle (RV) wasenlarged with tricuspid annular plane systolic excursion > 23 mm and mitralregurgitation grade III, left ventricular (LV) size and function showed to be normalwith an ejection fraction of 56% without wall motion abnormalities. However, all LVregions moved in almost the same counterclockwise direction, confirming absence of LVtwist, called "rigid body rotation" (RBR) (Figure1). The mean global LV radial, circumferential, longitudinal, 3D and area strainparameters showed to be 11.5 ± 10.0%, -25.5 ± 15.4%, -18.6 ± 10.2%,15.2 ± 10.8% and -34.7 ± 20.8%, respectively. EA is a congenital heartdefect in which septal and posterior leaflets of the tricuspid valve are displacedtowards the RV apex, leading to RV partial atrialization, although the anatomic annulusof the valve is in the normal position.1 Malformation and displacement of the anterior leaflet can also bepresent. To the best of our knowledge, this is the first report to demonstrate LV-RBR, aknown feature in LV myocardial mechanics, in a single patient with unrepaired EA. LV-RBRcould be partially explained by the impaired ventricle-to-ventricle interactions due todisplaced tricuspid valve leaflet attachments, alterations in the anatomic myocardialfiber orientation, but other reasons could also not be excluded.


Left Ventricular Rigid Body Rotation in Ebstein's Anomaly from the MAGYAR-Path Study.

Nemes A, Havasi K, Domsik P, Kalapos A, Forster T - Arq. Bras. Cardiol. (2016)

Apical 4-chamber (A) and 2-chamber (B) views and short–axis views (C3, C5,C7) at different levels of the left ventricle (LV) extracted from thethree-dimensional (3D) echocardiographic dataset are shown in the patientwith Ebstein’s anomaly. The 3D image of the LV and calculated LV volumetricand functional characteristics (EDV: end-diastolic volume; ESV: end-systolicvolume; EF: ejection fraction) are also demonstrated together with LV apical(white arrow), mid-ventricular and basal (dashed arrow) rotations in thesame counterclockwise direction, confirming absence of the LV twist, called“rigid body rotation”.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940155&req=5

f1: Apical 4-chamber (A) and 2-chamber (B) views and short–axis views (C3, C5,C7) at different levels of the left ventricle (LV) extracted from thethree-dimensional (3D) echocardiographic dataset are shown in the patientwith Ebstein’s anomaly. The 3D image of the LV and calculated LV volumetricand functional characteristics (EDV: end-diastolic volume; ESV: end-systolicvolume; EF: ejection fraction) are also demonstrated together with LV apical(white arrow), mid-ventricular and basal (dashed arrow) rotations in thesame counterclockwise direction, confirming absence of the LV twist, called“rigid body rotation”.
Mentions: A 70-year-old female patient with Ebstein's anomaly (EA) that had never undergonepalliation was assessed (the case originates from the MAGYAR-Path Study). Completetwo-dimensional (2D) Doppler and three-dimensional (3D) speckle-trackingechocardiography were carried out with commercially available Toshiba Artida™echocardiography equipment. During 2D echocardiography, the septal leaflet-tricuspidannulus distance showed to be 25 mm, confirming EA. While the right ventricle (RV) wasenlarged with tricuspid annular plane systolic excursion > 23 mm and mitralregurgitation grade III, left ventricular (LV) size and function showed to be normalwith an ejection fraction of 56% without wall motion abnormalities. However, all LVregions moved in almost the same counterclockwise direction, confirming absence of LVtwist, called "rigid body rotation" (RBR) (Figure1). The mean global LV radial, circumferential, longitudinal, 3D and area strainparameters showed to be 11.5 ± 10.0%, -25.5 ± 15.4%, -18.6 ± 10.2%,15.2 ± 10.8% and -34.7 ± 20.8%, respectively. EA is a congenital heartdefect in which septal and posterior leaflets of the tricuspid valve are displacedtowards the RV apex, leading to RV partial atrialization, although the anatomic annulusof the valve is in the normal position.1 Malformation and displacement of the anterior leaflet can also bepresent. To the best of our knowledge, this is the first report to demonstrate LV-RBR, aknown feature in LV myocardial mechanics, in a single patient with unrepaired EA. LV-RBRcould be partially explained by the impaired ventricle-to-ventricle interactions due todisplaced tricuspid valve leaflet attachments, alterations in the anatomic myocardialfiber orientation, but other reasons could also not be excluded.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

A 70-year-old female patient with Ebstein's anomaly (EA) that had never undergone During 2D echocardiography, the septal leaflet-tricuspid annulus distance showed to be 25 mm, confirming EA... However, all LV regions moved in almost the same counterclockwise direction, confirming absence of LV defect in which septal and posterior leaflets of the tricuspid valve are displaced towards the RV apex, leading to RV partial atrialization, although the anatomic annulus known feature in LV myocardial mechanics, in a single patient with unrepaired EA... LV-RBR could be partially explained by the impaired ventricle-to-ventricle interactions due to displaced tricuspid valve leaflet attachments, alterations in the anatomic myocardial fiber orientation, but other reasons could also not be excluded.

No MeSH data available.


Related in: MedlinePlus