The effect of loading alterations on left ventricular torsion

A simultaneous catheterization and two-dimensional speckle tracking echocardiographic study

Sung Ji Park, Rick A. Nishimura, Barry A Borlaug, Paul Sorajja, Jae Kuen Oh

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Aims Left ventricular torsion (LVtor) measures the rotational deformation of the myocardium and plays an important role in LV contraction and filling. Two-dimensional (2D) speckle tracking echocardiography (STE) has been validated as a reproducible non-invasive technique to assess LVtor. LVtor is altered in many disease states, but the effects of loading conditions on LVtor have not been established. The aim of this study was to evaluate the effect of load alteration on LVtor as assessed by 2D STE. Methods and results Simultaneous echocardiographic imaging and high-fidelity left ventricular pressure measurements were performed in 17 patients with a normal ejection fraction (mean 61 ± 10) before and after infusion of nitroprusside. All measurements were obtained simultaneously at baseline and then during a steady-state infusion of nitroprusside. Nitroprusside caused a decrease in LV systolic pressure, a decrease in effective arterial elastance (Ea), and a decrease in LV filling pressures. There was a faster rate of LV relaxation with nitroprusside with a decrease in tau from 53 ± 18 to 33 ± 14 ms (P < 0.005). Peak LVtor, apical rotation, twisting rate (TR), and untwisting rate (UTR) each increased after nitroprusside infusion when compared with baseline (P < 0.001). A correlation was found between the change in LV filling pressure and the change of LVtor (r = -0.54, P = 0.02), TR (r = -0.50, P = 0.04), and UTR (r = 0.54, P = 0.02). There was a significant correlation between the change of LVtor and change of Ea (r = -0.66, P < 0.05). Conclusion LV torsion, TRs, and UTRs are all enhanced in the setting of drug-induced vasodilation, indicating substantial load dependence. These findings must be taken into consideration when evaluating LVtor in disease states.

Original languageEnglish (US)
Pages (from-to)770-777
Number of pages8
JournalEuropean Journal of Echocardiography
Volume11
Issue number9
DOIs
StatePublished - Oct 2010

Fingerprint

Nitroprusside
Catheterization
Echocardiography
Untranslated Regions
Pressure
Ventricular Pressure
Vasodilation
Myocardium
Blood Pressure
Pharmaceutical Preparations

Keywords

  • Diastole
  • Echocardiography
  • Speckle tracking imaging
  • Torsion
  • Untwisting

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{4ddd4bcc88744bc59a02b4acd443a60e,
title = "The effect of loading alterations on left ventricular torsion: A simultaneous catheterization and two-dimensional speckle tracking echocardiographic study",
abstract = "Aims Left ventricular torsion (LVtor) measures the rotational deformation of the myocardium and plays an important role in LV contraction and filling. Two-dimensional (2D) speckle tracking echocardiography (STE) has been validated as a reproducible non-invasive technique to assess LVtor. LVtor is altered in many disease states, but the effects of loading conditions on LVtor have not been established. The aim of this study was to evaluate the effect of load alteration on LVtor as assessed by 2D STE. Methods and results Simultaneous echocardiographic imaging and high-fidelity left ventricular pressure measurements were performed in 17 patients with a normal ejection fraction (mean 61 ± 10) before and after infusion of nitroprusside. All measurements were obtained simultaneously at baseline and then during a steady-state infusion of nitroprusside. Nitroprusside caused a decrease in LV systolic pressure, a decrease in effective arterial elastance (Ea), and a decrease in LV filling pressures. There was a faster rate of LV relaxation with nitroprusside with a decrease in tau from 53 ± 18 to 33 ± 14 ms (P < 0.005). Peak LVtor, apical rotation, twisting rate (TR), and untwisting rate (UTR) each increased after nitroprusside infusion when compared with baseline (P < 0.001). A correlation was found between the change in LV filling pressure and the change of LVtor (r = -0.54, P = 0.02), TR (r = -0.50, P = 0.04), and UTR (r = 0.54, P = 0.02). There was a significant correlation between the change of LVtor and change of Ea (r = -0.66, P < 0.05). Conclusion LV torsion, TRs, and UTRs are all enhanced in the setting of drug-induced vasodilation, indicating substantial load dependence. These findings must be taken into consideration when evaluating LVtor in disease states.",
keywords = "Diastole, Echocardiography, Speckle tracking imaging, Torsion, Untwisting",
author = "Park, {Sung Ji} and Nishimura, {Rick A.} and Borlaug, {Barry A} and Paul Sorajja and Oh, {Jae Kuen}",
year = "2010",
month = "10",
doi = "10.1093/ejechocard/jeq064",
language = "English (US)",
volume = "11",
pages = "770--777",
journal = "European Heart Journal Cardiovascular Imaging",
issn = "2047-2404",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - The effect of loading alterations on left ventricular torsion

T2 - A simultaneous catheterization and two-dimensional speckle tracking echocardiographic study

AU - Park, Sung Ji

AU - Nishimura, Rick A.

AU - Borlaug, Barry A

AU - Sorajja, Paul

AU - Oh, Jae Kuen

PY - 2010/10

Y1 - 2010/10

N2 - Aims Left ventricular torsion (LVtor) measures the rotational deformation of the myocardium and plays an important role in LV contraction and filling. Two-dimensional (2D) speckle tracking echocardiography (STE) has been validated as a reproducible non-invasive technique to assess LVtor. LVtor is altered in many disease states, but the effects of loading conditions on LVtor have not been established. The aim of this study was to evaluate the effect of load alteration on LVtor as assessed by 2D STE. Methods and results Simultaneous echocardiographic imaging and high-fidelity left ventricular pressure measurements were performed in 17 patients with a normal ejection fraction (mean 61 ± 10) before and after infusion of nitroprusside. All measurements were obtained simultaneously at baseline and then during a steady-state infusion of nitroprusside. Nitroprusside caused a decrease in LV systolic pressure, a decrease in effective arterial elastance (Ea), and a decrease in LV filling pressures. There was a faster rate of LV relaxation with nitroprusside with a decrease in tau from 53 ± 18 to 33 ± 14 ms (P < 0.005). Peak LVtor, apical rotation, twisting rate (TR), and untwisting rate (UTR) each increased after nitroprusside infusion when compared with baseline (P < 0.001). A correlation was found between the change in LV filling pressure and the change of LVtor (r = -0.54, P = 0.02), TR (r = -0.50, P = 0.04), and UTR (r = 0.54, P = 0.02). There was a significant correlation between the change of LVtor and change of Ea (r = -0.66, P < 0.05). Conclusion LV torsion, TRs, and UTRs are all enhanced in the setting of drug-induced vasodilation, indicating substantial load dependence. These findings must be taken into consideration when evaluating LVtor in disease states.

AB - Aims Left ventricular torsion (LVtor) measures the rotational deformation of the myocardium and plays an important role in LV contraction and filling. Two-dimensional (2D) speckle tracking echocardiography (STE) has been validated as a reproducible non-invasive technique to assess LVtor. LVtor is altered in many disease states, but the effects of loading conditions on LVtor have not been established. The aim of this study was to evaluate the effect of load alteration on LVtor as assessed by 2D STE. Methods and results Simultaneous echocardiographic imaging and high-fidelity left ventricular pressure measurements were performed in 17 patients with a normal ejection fraction (mean 61 ± 10) before and after infusion of nitroprusside. All measurements were obtained simultaneously at baseline and then during a steady-state infusion of nitroprusside. Nitroprusside caused a decrease in LV systolic pressure, a decrease in effective arterial elastance (Ea), and a decrease in LV filling pressures. There was a faster rate of LV relaxation with nitroprusside with a decrease in tau from 53 ± 18 to 33 ± 14 ms (P < 0.005). Peak LVtor, apical rotation, twisting rate (TR), and untwisting rate (UTR) each increased after nitroprusside infusion when compared with baseline (P < 0.001). A correlation was found between the change in LV filling pressure and the change of LVtor (r = -0.54, P = 0.02), TR (r = -0.50, P = 0.04), and UTR (r = 0.54, P = 0.02). There was a significant correlation between the change of LVtor and change of Ea (r = -0.66, P < 0.05). Conclusion LV torsion, TRs, and UTRs are all enhanced in the setting of drug-induced vasodilation, indicating substantial load dependence. These findings must be taken into consideration when evaluating LVtor in disease states.

KW - Diastole

KW - Echocardiography

KW - Speckle tracking imaging

KW - Torsion

KW - Untwisting

UR - http://www.scopus.com/inward/record.url?scp=77958005037&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77958005037&partnerID=8YFLogxK

U2 - 10.1093/ejechocard/jeq064

DO - 10.1093/ejechocard/jeq064

M3 - Article

VL - 11

SP - 770

EP - 777

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

SN - 2047-2404

IS - 9

ER -