Characteristics of left ventricular rotational mechanics in patients with systemic amyloidosis, systemic hypertension and normal left ventricular mass

Abstract

Our results show that amyloidosis and systemic hypertension produce both LV twist and untwist rate enhancement before LV hypertrophy is developed. In patients with amyloidosis irrespectively of LV infiltration degree, a significant LV untwisting rate peak delay occurs suggesting that different aetiology of cardiac involvement could differently affect LV untwisting rate.

Prognostic value of depressed midwall systolic function in cardiac light-chain amyloidosis

“…In this setting, longitudinal systolic performance has already been characterized by M-Mode analysis of the mitral annulus excursion [55], tissue Doppler evaluation of myocardial velocity [56], and by strain-strain rate analysis by speckle-tracking [35,57,58]. Also rotational mechanics has been studied, showing a significant left ventricular untwisting rate peak delay in patients with cardiac amyloidosis [59]. Assessment of systolic performance at the midwall represents an accurate method to quantify circumferential left ventricular systolic function in the setting of concentric hypertrophy, as extensively documented in the setting of chronic pressure-overload [11][12][13][14].…”

Altered Left Ventricular Twist Is Associated with Clinical Severity in Adults and Adolescents with Homozygous Sickle Cell Anemia

“…Subepicardial fibers are more closely related to rotational dynamics, whereas subendocardial fibers are more intimately tied to longitudinal contraction. 36,37 This is a similar pathway to what has been established in patients with ventricular hypertrophy. 37 Considering the multisystemic injury present in SCA, evaluating ventricular rotation in this population could represent an accurate method of identifying incipient myocardial attacks.…”

Longitudinal strain of left ventricular basal segments and E/e′ ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study

“…2D speckle tracking echocardiography (STE) is a non‐Doppler technique that allows quantification of myocardial deformation . Using 2DSTE, both twisting and untwisting motions have been shown to increase in AL without cardiac involvement while they reduce when CA develops . Also circumferential, radial, and longitudinal strains are reduced in advanced CA compared with both hypertrophic cardiomyopathy and secondary LVH, these findings were confirmed also using 3D‐derived STE …”

“…11 Using 2DSTE, both twisting and untwisting motions have been shown to increase in AL without cardiac involvement while they reduce when CA develops. 12,13 Also circumferential, radial, and longitudinal strains are reduced in advanced CA compared with both hypertrophic cardiomyopathy and secondary LVH, 14 these findings were confirmed also using 3D-derived STE. 15 Currently, a comprehensive assessment of LV systolic myocardial deformation, including twisting and torsion, requires an offline, timeexpensive analysis on dedicated workstations, which can be problematic for a clinical application.…”