Left Ventricular Rotation, Twist and Untwist: Physiological Role and Clinical Relevance

Pavlyukova, E. N.; Kuzhel, D. A.; Matyushin, G. V.; Savchenko, E. A.; Filippova, S. A.

doi:10.20996/1819-6446-2015-11-1-68-78

Cited by 11 publications

(1 citation statement)

References 56 publications

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“…При поражении только субэндокардиального слоя параметры деформации и скручивания чаще всего остаются неизменными. Однако по мере увеличения трансмуральности некроза и степени вовлечения среднего и субэпикардиальных слоёв отмечается развитие дисфункции как систолического скручивания, так и диастолического раскручивания [13]. Это, в свою очередь, может сопровождаться стойким и выраженным снижением деформационных характеристик миокарда, особенно у пациентов с Q-ИМ, отражающим больший объём повреждения.…”

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Echocardiographic parameters of the left ventricle in patients after Q-wave and non-Q-wave myocardial infarction

Oleynikov,

Salyamova,

Golubeva

et al. 2023

Russ J Cardiol

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Aim. To perform a dynamic assessment and comparative analysis of non-invasive parameters of myocardial function in patients with Q-wave and non-Q-wave myocardial infarction (MI) during 24-week follow-up after revascularization.Material and methods. A total of 95 patients with acute MI were included. On days 7-9 and after 24 weeks, speckle tracking echocardiography was performed with assessment of global longitudinal (GLS), global circumferential (GCS) and global radial strain (GRS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE).Results. Taking into account the presence/absence of the Q wave, the subjects were divided into two groups: Q-wave MI — 66 patients (69,5%), non-Q-wave MI — 29 (30,5%) people. In the Q-wave MI group, by the 24th week, most parameters of myocardial performance were significantly lower than in the comparison group. In group 1, GWE was 93 (87; 96)% vs 96 (91; 97)% (p=0,04) in group 2; GWI — 1429±444,1 and 1653,3±385,84 mm Hg %, respectively (p=0,02). The GCW level in the Q-wave MI group was 1640±477,8 mm Hg % vs 1852,9±440,88 mm Hg % in the non-Q-wave MI group (p=0,04). Subsequently, a favorable increase in GLS (p=0,01), GWI (p=0,04), GWE (p=0,01), GCW (p=0,03) was revealed in the non-Q-wave MI group.Conclusion. The results obtained suggest that non-invasive parameters of myocardial performance can be used to assess transient ischemic dysfunction due to myocardial stunning, expressed to varying severity in patients with Q-wave MI and non-Q-wave MI.

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Echocardiographic parameters of the left ventricle in patients after Q-wave and non-Q-wave myocardial infarction

Oleynikov,

Salyamova,

Golubeva

et al. 2023

Russ J Cardiol

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Early markers of pathological left ventricular remodeling in patients after ST-elevation myocardial infarction according to speckle-tracking echocardiography

et al. 2022

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Aim. To assess early predictors of pathological remodeling in patients after ST-elevation myocardial infarction (STEMI) using speckle-tracking echocardiography (STE).Material and methods. The study included 114 STEMI patients aged 52 (44; 58) years. A two-dimensional echocardiography was performed with the analysis of standard parameters and STE with an analysis of strain and rotational characteristics of the myocardium. In addition, brain natriuretic peptide and troponin-I concentration was determined. The development of pathological post-infarction remodeling within 12-month follow-up was assessed as an end point. Depending on the outcome, 2 groups were formed: group 1 — patients with pathological remodeling (PR), n=45 (39,5%), group 2 — patients without PR, n=69 (60,5%).Results. Early remodeling was detected in 24 (53,3%) people, mid-term — in 15 (33,4%), and late remodeling — in 6 (13,3%). In the PR group, heart failure (HF) was detected in 100% of patients, while in non-PR group, 23 (33,3%) patients had no signs of HF.In the early period of myocardial infarction, each of following indicators with high sensitivity and specificity predicts postinfarction pathological dilatation: global longitudinal strain (GLS) <11,7%, global circular strain (GCS) <12,4%, and a Twist decrease to 7,8o. A multivariate logistic regression model was created for the formation of pathological remodeling in patients with STEMI, which included GLS, global radial deformation (GRS), end-systolic volume index (ESVI), determined on days 7-9 of STEMI.Conclusion. GLS, GCS, and left ventricular Twist are independent highly sensitive and specific predictors of pathological remodeling. The following early predictors of postinfarction pathological dilatation have been established: reduced GLS in combination with higher GRS and left ventricular ESVI.

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Influence of mitral transcatheter edge-to-edge repair in patients with severe mitral regurgitation on left ventricle function

Makeev,

Saidova,

Imaev

2024

Russ J Cardiol

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Aim. To study the changes of left ventricular (LV) contractile function in patients with severe mitral valve (MV) insufficiency with assessment of global longitudinal strain (GLS) indicators and LV myocardial function after the mitral transcatheter edge-to-edge repair (TEER) within 12-month follow-up.Material and methods. The study consisted of 43 patients with severe mitral regurgitation (MR) as follows: 23 patients with functional MR (FMR), 20 patients with degenerative MR (DMR). A comprehensive echocardiographic study, including speckle tracking echocardiography, was performed at baseline, 4-5 days, 6 and 12 months after TEER. Standard structural and functional indicators of the LV, LV GLS and myocardial performance parameters were assessed.Results. The early postoperative period (4-5 days) was characterized by a decrease in global constructive work (GCW) (FMR group — from 977 [684; 1253] to 857 [736; 1488] mm Hg%, (p=0,038); DMR group — from 1458 [1283; 1848] to 1350 [1010; 1488] mm Hg% (p=0,011)), an increase in global wasted work (GWW) (FMR group — from 177 [130; 280] to 336 [242; 388] mm Hg% (p=0,004); DMR group — from 128 [81; 172] to 216 [164; 279] mm Hg% (p=0,043)), which was accompanied by a decrease in myocardial efficiency (FMR group — from 81,5 [77; 87] to 76 [73; 79]%, (p=0,021); DMR group — from 90 [85; 93] to 82 [79; 85]% (p=0,018)). After 12-month follow-up, there was a significant increase in GCW relative to the initial values in both cohorts of patients as follows: FMR group — to 1128 [890; 1711] mm Hg% (p=0,048); DMR group — to 1818 [1478; 2034] mm Hg% (p<0,001). There was also an increase in GWW in the FMR group to 255 [214; 363] mm Hg% (p=0,024) and in the DMR group to 230 [140; 270] mm Hg% (p=0,043). There were no significant improvement of LV GLS in both groups.Conclusion. The early postoperative period after TEER was characterized by a temporary deterioration in all LV performance parameters, which recovered by 6 and 12 months of follow-up. Myocardial function restoration by one year of follow-up was noted due to an increase in GCW. LV GLS and ejection fraction did not change significantly by 1 year of follow-up compared to baseline values.

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Left Ventricular Rotation, Twist and Untwist: Physiological Role and Clinical Relevance

Cited by 11 publications

References 56 publications

Echocardiographic parameters of the left ventricle in patients after Q-wave and non-Q-wave myocardial infarction

Echocardiographic parameters of the left ventricle in patients after Q-wave and non-Q-wave myocardial infarction

Early markers of pathological left ventricular remodeling in patients after ST-elevation myocardial infarction according to speckle-tracking echocardiography

Influence of mitral transcatheter edge-to-edge repair in patients with severe mitral regurgitation on left ventricle function

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