Assessment of Left Ventricular Torsional Deformation by Doppler Tissue Imaging

Notomi, Yuichi; Setser, Randolph M.; Shiota, Takahiro; Martin-Miklovic, Maureen G.; Weaver, Joan A.; Popović, Zoran B.; Yamada, Hirotsugu; Greenberg, Neil L.; White, Richard D.; Thomas, James D.

doi:10.1161/01.cir.0000157151.10971.98

Cited by 214 publications

(59 citation statements)

References 50 publications

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“…Tagged MRI has been considered the reference standard for noninvasive LVrot assessment. 8,18 However, MRI is of limited use because of lower temporal resolution and dissipation of tags during diastole. It is also time-consuming, technically demanding, and expensive.…”

Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

“…20 This was followed by attempts to decipher rotational mechanics using DTI. 18 However, the angle dependency of DTI remains a major limitation. 21,22 Two-dimensional STI, which is based on 2D tracking of unique speckle patterns created by the constructive and destructive interference of ultrasound beams within tissue, is independent of cardiac translation and angle dependency.…”

Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

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Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Zhou

Ashraf

et al. 2010

Journal of Ultrasound in Medicine

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Objective. Left ventricular (LV) twist is manifested in oppositely directed apical and basal rotation. We studied a new 3-dimensional (3D) echocardiography program (wall motion tracking; Toshiba America Medical Systems, Inc, Tustin, CA) for left ventricular rotation. Methods. We used a rotation model with a variable-speed motor to rotate hearts in a water bath. We studied 10 freshly harvested pig hearts, which were mounted on the rotary actuator of our twist phantom with the heart base rotating and the apex held fixed to avoid translational motion, at rotations of 0°, 15°, 20°, and 25°. Full-volume 3D image loops were acquired on a Toshiba Aplio Artida ultrasound system at a maximized frame rate. Results. As the actual heart rotation increased, computed segmental and global rotation also increased accordingly, with the measured rotations of the basal and middle segments greater than that of the apex (both P < .001). Segmental and global rotation at all 3 levels correlated well with the actual rotation (base: r = 0.93; middle: r = 0.92; apex: r = 0.82; global: r = 0.95; all P < .001). Conclusions. The new 3D program tracked LV rotation accurately. Key words: left ventricular rotation; speckle tracking; 3-dimensional imaging. esearch in clinical deformation cardiac mechanics has recently been focused on 2-dimensional (2D) left ventricular (LV) deformation studies, including LV twist and LV rotation (LVrot). 1 Left ventricular twist may be related to the helical fiber orientation of the LV, which results in opposing rotational directions of the apex and the base and which determines the magnitude of this torsional deformation. 2,3 It has been proposed that LV twist is a sensitive marker of changes in both regional and global LV function. [4][5][6] Recently, efforts have focused on 2D speckle-tracking imaging (STI) to assess LVrot. [7][8][9] Several studies have shown that 2D STI gives equivalent results when compared to magnetic resonance imaging (MRI) or Doppler tissue imaging (DTI) for measuring LVrot. 9 However, because of the 3-dimensional (3D) nature of cardiac deformation, 2D STI based on 2D imaging may not be robust enough for LVrot measurement because of speckle decorrelation or the loss of some speckles due to elevational

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Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

Section: Left Ventricular Rotation and Clinical Implicationsmentioning

confidence: 99%

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Zhou

Ashraf

et al. 2010

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…Torsion can be measured by TDI and 2D speckle tracking, with both methods correlating with MRI 155 , 156 . Speckle tracking is the preferred technique given its angle independence and higher reproducibility; however, studies utilising this modality have demonstrated incongruent results.…”

Section: Torsion/twist Mechanicsmentioning

confidence: 99%

Echocardiographic evaluation of diastolic heart failure

Thomas

2010

Australas J Ultrason Med

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“…The proper basal and apical levels were determined utilizing previously published criteria. 20 Offline analysis was performed on the digitally stored images using customized software on a personal computer workstation (EchoPAC; GE Vingmed, Noblesville, IN). All measurements of LV function and twist mechanics were made in a blinded fashion to exclude operator bias.…”

Section: Echocardiography Protocolmentioning

confidence: 99%

Left Ventricular Torsional Mechanics in Uncomplicated Pregnancy

Yoon

Song²,

Megalla³

et al. 2011

Clinical Cardiology

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Background: Alterations in left ventricular (LV) twist (torsion) and untwist have been described for a variety of physiologic and pathologic conditions. Little information is available regarding changes in these parameters during normal pregnancy. Hypothesis: Pregnancy is associated with significant changes in LV torsional mechanics. Methods: Left ventricular twist and untwist was measured in 32 pregnant females (mean gestation 199 ± 48 d) and 23 nonpregnant controls using speckle-tracking echocardiography.Results: Left ventricular ejection fraction (68 ± 5% vs 66 ± 5%) was similar between the groups (P not significant). There was a significant increase in peak LV twist from nonpregnant controls (9.4 ± 3.7 degrees) to second-trimester (12.0 ± 4.2 degrees) and third-trimester subjects (12.6 ± 5.9 degrees, all P < 0.05). Peak LV twist velocity was also increased in second-and third-trimester groups compared with controls (94 ± 24 degrees/sec and 93 ± 30 vs 64 ± 21 degrees/sec, respectively, both P < 0.05). Both peak untwist velocity and time to peak untwist velocity were not significantly different between groups (P not significant). Multiple regression analysis indicate that only systolic blood pressure (r = 0.394, P = 0.005) was an independent predictor for increased LV torsion. Conclusions: There are significant changes in LV torsional indices during the course of pregnancy, whereas untwist parameters remain unchanged. Blood pressure is independently associated with increased torsion during pregnancy. IntroductionPregnancy is associated with reversible adaptations in maternal systolic and diastolic left ventricular (LV) function. 1,2 Prior studies have shown increased preload and cardiac output, 3 -5 decreased systemic vascular resistance, 2,6 and increased LV mass and wall thickness 7 during pregnancy. Changes in LV fractional shortening are less well-defined, with the literature offering conflicting data. 8 -10 Little information is available concerning alterations in LV torsion (LV Tor ), the helical twisting motion of the LV about its longitudinal long axis. 11 Speckle-tracking echocardiography (STE) is a noninvasive method that allows for rapid, objective quantification of LV Tor . 12 Numerous studies have demonstrated that STE can accurately quantify differences in LV Tor associated with various pathophysiologic conditions. 13 -16 We used STE to measure LV Tor in healthy pregnant women and nonpregnant controls.

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Assessment of Left Ventricular Torsional Deformation by Doppler Tissue Imaging

Cited by 214 publications

References 50 publications

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Echocardiographic evaluation of diastolic heart failure

Left Ventricular Torsional Mechanics in Uncomplicated Pregnancy

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