Ventricular twist in isolated left ventricular noncompaction

Abstract

c o r e t v a s a 5 6 ( 2 0 1 4 ) e 4 7 1 -e 4 7 7Left ventricle twist Isolated left ventricular noncompaction a b s t r a c tThe study aimed at assessing the rotational motion of the left ventricle around the long axis in patients affected by isolated left ventricular noncompaction (LVNC) and comparing their results with those of healthy volunteers. Patients and methods: The study comprised eight patients with LVNC confirmed by echocardiography and magnetic resonance imaging (mean age 41 AE 19 years; four males; left ventricular ejection fraction [LVEF] 45 AE 25%). The patients were divided into Group A with an LVEF above 50% (four patients; one male) and Group B with an LVEF below 50% (four patients; three males). For both groups, age-and sex-matched volunteers were found. The focus was on myocardial twist, rotation of the LV apex and base, times to reach maximal apical and maximal basal rotation and myocardial twist, as well as correlations between systolic function, rotation of individual planes and LV twist. Results: When comparing LVNC patients with healthy volunteers, there were statistically significantly decreased systolic function ( p = 0.004), larger diastolic dimension ( p = 0.045) and decreased apical rotation ( p = 0.01). Left ventricular twist was significantly decreased in the group of patients with LVNC and systolic dysfunction ( p = 0.04). A statistically significant correlation was found between systolic function and LV apical rotation. Conclusion: The study showed a significant decrease in apical rotation and twist mechanism of the LV as measured using two-dimensional speckle tracking in patients with LVNC and decreased LV systolic function. Measuring these parameters could contribute to more accurate diagnosis and risk stratification of patients affected by this condition.

Cardiovascular magnetic resonance based diagnosis of left ventricular non-compaction cardiomyopathy: impact of cine bSSFP strain analysis

“…The absence of a significant difference in LV twist and torsion is inconsistent with previous STE studies demonstrating significantly decreased twist in LVNC phenotype patients compared to healthy subjects [17,18]. A disadvantage of CMR FT compared to STE that may partly account for these differences is the fairly uniform water content and thus homogenous signal within myocardium on bSSFP sequences.…”

“…Although there are multiple studies describing the strain characteristics of LVNC assessed by STE [15][16][17][18], CMR FT has some potential advantages that may provide a more accurate and reproducible assessment. The comparatively unrestricted access to multi-planar views and excellent contrast between the myocardium and blood pool allows reproducible imaging planes and clear boundary points for the measurement of myocardial strain [19].…”

“…In order to expand beyond pure morphologic features and global volumetric parameters of cardiac function in the diagnosis and assessment of ischemic and nonischemic cardiomyopathies, quantitative assessment of myocardial deformation by strain analysis has developed over recent years. Speckle-tracking echocardiography (STE) has demonstrated abnormal patterns of LV myocardial strain and torsion in LVNC including decreased radial, circumferential and longitudinal strain, decreased LV twist and abnormal patterns of ventricular rotation [15][16][17][18]. Strain analysis by CMR feature tracking (FT) using routine cine balanced steady-state free precession (bSSFP) data sets can reproducibly quantify myocardial deformation across multiple parameters [19].…”

Noncompaction Cardiomyopathy—History and Current Knowledge for Clinical Practice

“…Further studies also showed impaired LV twist and the presence of rigid body rotation in NCCM but not in LVHT. A correlation between LV twist reduction in apical rotation and LV function was observed [ 77 ]. Table 5 shows an overview of different echocardiographic criteria.…”