Background: Traditionally the use of Left ventricular ejection fraction (LVEF) for assessment of left ventricular (LV) systolic. Function is the most widely used method. However, this method is inaccurate after acute MI, this attributed to the development of wall-motion abnormalities after acute MI; Inaddition, the biplane Simpson method calculation is inaccurate, because it relys on geometric assumptions. Recently, the use of two-dimensional speckle-tracking imaging has facilitated noninvasive measurement of LV torsion. Objective: The aim of this study was to use speckle-tracking echocardiography to assess apical rotation in patients with anterior and inferior myocardial infarction (MI). Patients and methods: The present study enrolled 54 patients with anterior or inferior MI, in addition to 20 healthy volunteers (matched for age and sex) as the control group. Using commercially available two-dimensional strain software, apical, basal rotation, and LV torsion were calculated. Basal and apical LV short-axis images were acquired for further off-line analysis. Results: Apical rotation was significantly reduced in the patient group compared with the control group (P<0.001). Consequently, torsion degree (P<0.001), torsion rate, and untwisting rate (P=0.007) were significantly reduced. There was a significant correlation between ejection fraction and apex rotation (r=0.466, P=0.044), torsion degree (r=0.499, P=0.03), and untwisting rate (r=−0.543, P<0.001). Correlation with basal rotation was nonsignificant, and thus measurement of apical rotation alone (rather than calculation of LV torsion) might provide a simple and accurate alternative for assessment of LV contractility. Conclusion: Apical rotation and torsion were decreased in ST-elevation MI, and this was statistically significant in patients with LV dysfunction.
| Published in | International Journal of Cardiovascular and Thoracic Surgery (Volume 7, Issue 6) |
| DOI | 10.11648/j.ijcts.20210706.12 |
| Page(s) | 64-69 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Apical Rotations, Ejection Fraction, Myocardial Infarction, Speckle-Tracking Echocardiography, Torsion
| [1] | Luo Y, Liu Y, Guan X, Zhang Y, Li J. Value of three dimen- sional-speckle tracking imaging for predicting left ventricu- lar function after non-ST-segment elevation myocardial in- farction with percutaneous coronary intervention. J Xray Sci Technol 2018; 26: 331–9. |
| [2] | Bastawy I, Ismail M, Hanna HF, El Kilany W. Speckle track- ing imaging as a predictor of left ventricular remodeling 6 months after first anterior ST elevation myocardial infarction in patients managed by primary percutaneous coronary intervention. Egypt Heart J 2018; 70: 343–52. |
| [3] | Ingels NB Jr, Hansen DE, Daughters GT II, Stinson EB, Alderman EL, Miller DC. Relation between longitudinal, circumferential, and oblique shortening and torsional deformation in the left ventricle of the transplanted human heart. Circ Res 1989; 64: 915–927. |
| [4] | Moon MR, Ingels NB Jr, Daughters GT II, Stinson EB, Hansen DE, Miller DC. Alterations in left ventricular twist mechanics with inotropic stimulation and volume loading in human subjects. Circulation 1994; 89: 142–150. |
| [5] | Kroeker CA, Tyberg JV, Beyar R. Effects of ischemia on left ventricular apex rotation. An experimental study in anesthetized dogs. Circulation 1995; 92: 3539–3548. |
| [6] | Monaster SS, Ahmad MK, Braik AG. Comparison between strain and strain rate in hypertensive patients with and without left ventricular hypertrophy: a speckle-tracking study. Menoufia Med J 2014; 27: 322–328. |
| [7] | Haberka M, Liszka J, Kozyra A, Finik M, Gąsior Z. Two-Di- mensional Speckle Tracking Echocardiography Prognostic Parameters in Patients after Acute Myocardial Infarction. Echocardiography 2015; 32: 54–60. |
| [8] | Lester SJ, Tajik AJ, Nishimura RA, Oh JK, Khandheria BK, Seward JB. Unlocking the mysteries of diastolic function: deciphering the Rosetta Stone 10 years later. J Am Coll Cardiol 2008; 51: 679–689. |
| [9] | Sengupta PP, Tajik AJ, Chandrasekaran K, Khandheria BK. Twist mechanics of the left ventricle: principles and application. JACC Cardiovasc Imaging 2008; 1: 366–376. |
| [10] | Toumanidis ST, Kaladaridou A, Bramos D, Skaltsiotes E, Agrios JN, Vasiladiotis N, et al. Apical rotation as an early indicator of left ventricular systolic dysfunction in acute anterior myocardial infarction: experimental study. Hellenic J Cardiol 2013; 54: 264–272. |
| [11] | Armitage P, Berry G, Mathhews JNS. Statistical methods in medical research. 4th ed. Wiley-Blackwell, Chicago, USA: Blackwell Scientific Publication; 2002. |
| [12] | Buchalter MB, Weiss JL, Rogers WJ, Zerhouni EA, Weisfeldt ML, Beyar R, Shapiro EP. Noninvasive quantification of left ventricular rotational deformation in normal humans using magnetic resonance imaging myocardial tagging. Circulation 1990; 81: 1236–1244. |
| [13] | Nagel E, Stuber M, Lakatos M, Scheidegger MB, Boesiger P, Hess OM. Cardiac rotation and relaxation after anterolateral myocardial infarction. Coron Artery Dis 2000; 11: 261–267. |
| [14] | Kim J, Weinsaft JW. Thrombosis and prognosis following ST-Elevation myocardial infarction: Left ventricular thrombus assessment by cardiac magnetic resonance. Circ Cardiovasc Imaging 2015; 8: e004098. |
| [15] | Nagel E, Stuber M, Burkhard B, Fischer SE, Scheidegger MB, Boesiger P, Hess OM. Cardiac rotation and relaxation in patients with aortic valve stenosis. Eur Heart J 2000; 21: 582–589. |
| [16] | Takeuchi M, Nishikage T, Nakai H, Kokumai M, Otani S, Lang RM. The assessment of left ventricular twist in anterior wall myocardial infarction using two-dimensional speckle tracking imaging. J Am Soc Echocardiogr 2007; 20: 36–44. |
| [17] | Govind SC, Gadiyaram VK, Quintana M, Ramesh SS, Saha S. Study of left ventricular rotation and torsion in the acute phase of ST- elevation myocardial infarction by speckle tracking echocardiography. Echocardiography 2010; 27: 45–49. |
| [18] | Garot J, Pascal O, Diébold B, Derumeaux G, Gerber BL, Dubois- Randé JL, et al. Alterations of systolic left ventricular twist after acute myocardial infarction. Am J Physiol Heart Circ Physiol 2002; 282: H357–H362. |
| [19] | Nucifora G, Marsan NA, Bertini M, Delgado V, Siebelink HM, van Werkhoven JM, et al. Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling. Circ Cardiovasc Imaging 2010; 3: 433–442. |
| [20] | Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ, et al. New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 2005; 112: 3149–3156. |
| [21] | Bansal M, Leano RL, Marwick TH. Clinical assessment of left ventricular systolic torsion: effects of myocardial infarction and ischemia. J Am Soc Echocardiogr 2008; 21: 887–894. |
| [22] | Blasen C, Codreanu A, Robert F, Meniconi N, Beissel J, Wagner DR. Measurement of ventricular twist by 2D speckle tracking early after acute myocardial infarction. Comparison between anterior and inferior infarction. Bull Soc Sci Med Grand Duche Luxemb 2009; 2: 115–129. |
APA Style
Mohamed Roshdy, Ramy Omar. (2021). The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function. International Journal of Cardiovascular and Thoracic Surgery, 7(6), 64-69. https://doi.org/10.11648/j.ijcts.20210706.12
ACS Style
Mohamed Roshdy; Ramy Omar. The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function. Int. J. Cardiovasc. Thorac. Surg. 2021, 7(6), 64-69. doi: 10.11648/j.ijcts.20210706.12
AMA Style
Mohamed Roshdy, Ramy Omar. The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function. Int J Cardiovasc Thorac Surg. 2021;7(6):64-69. doi: 10.11648/j.ijcts.20210706.12
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijcts.20210706.12,
author = {Mohamed Roshdy and Ramy Omar},
title = {The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function},
journal = {International Journal of Cardiovascular and Thoracic Surgery},
volume = {7},
number = {6},
pages = {64-69},
doi = {10.11648/j.ijcts.20210706.12},
url = {https://doi.org/10.11648/j.ijcts.20210706.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20210706.12},
abstract = {Background: Traditionally the use of Left ventricular ejection fraction (LVEF) for assessment of left ventricular (LV) systolic. Function is the most widely used method. However, this method is inaccurate after acute MI, this attributed to the development of wall-motion abnormalities after acute MI; Inaddition, the biplane Simpson method calculation is inaccurate, because it relys on geometric assumptions. Recently, the use of two-dimensional speckle-tracking imaging has facilitated noninvasive measurement of LV torsion. Objective: The aim of this study was to use speckle-tracking echocardiography to assess apical rotation in patients with anterior and inferior myocardial infarction (MI). Patients and methods: The present study enrolled 54 patients with anterior or inferior MI, in addition to 20 healthy volunteers (matched for age and sex) as the control group. Using commercially available two-dimensional strain software, apical, basal rotation, and LV torsion were calculated. Basal and apical LV short-axis images were acquired for further off-line analysis. Results: Apical rotation was significantly reduced in the patient group compared with the control group (P<0.001). Consequently, torsion degree (P<0.001), torsion rate, and untwisting rate (P=0.007) were significantly reduced. There was a significant correlation between ejection fraction and apex rotation (r=0.466, P=0.044), torsion degree (r=0.499, P=0.03), and untwisting rate (r=−0.543, P<0.001). Correlation with basal rotation was nonsignificant, and thus measurement of apical rotation alone (rather than calculation of LV torsion) might provide a simple and accurate alternative for assessment of LV contractility. Conclusion: Apical rotation and torsion were decreased in ST-elevation MI, and this was statistically significant in patients with LV dysfunction.},
year = {2021}
}
TY - JOUR T1 - The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function AU - Mohamed Roshdy AU - Ramy Omar Y1 - 2021/11/23 PY - 2021 N1 - https://doi.org/10.11648/j.ijcts.20210706.12 DO - 10.11648/j.ijcts.20210706.12 T2 - International Journal of Cardiovascular and Thoracic Surgery JF - International Journal of Cardiovascular and Thoracic Surgery JO - International Journal of Cardiovascular and Thoracic Surgery SP - 64 EP - 69 PB - Science Publishing Group SN - 2575-4882 UR - https://doi.org/10.11648/j.ijcts.20210706.12 AB - Background: Traditionally the use of Left ventricular ejection fraction (LVEF) for assessment of left ventricular (LV) systolic. Function is the most widely used method. However, this method is inaccurate after acute MI, this attributed to the development of wall-motion abnormalities after acute MI; Inaddition, the biplane Simpson method calculation is inaccurate, because it relys on geometric assumptions. Recently, the use of two-dimensional speckle-tracking imaging has facilitated noninvasive measurement of LV torsion. Objective: The aim of this study was to use speckle-tracking echocardiography to assess apical rotation in patients with anterior and inferior myocardial infarction (MI). Patients and methods: The present study enrolled 54 patients with anterior or inferior MI, in addition to 20 healthy volunteers (matched for age and sex) as the control group. Using commercially available two-dimensional strain software, apical, basal rotation, and LV torsion were calculated. Basal and apical LV short-axis images were acquired for further off-line analysis. Results: Apical rotation was significantly reduced in the patient group compared with the control group (P<0.001). Consequently, torsion degree (P<0.001), torsion rate, and untwisting rate (P=0.007) were significantly reduced. There was a significant correlation between ejection fraction and apex rotation (r=0.466, P=0.044), torsion degree (r=0.499, P=0.03), and untwisting rate (r=−0.543, P<0.001). Correlation with basal rotation was nonsignificant, and thus measurement of apical rotation alone (rather than calculation of LV torsion) might provide a simple and accurate alternative for assessment of LV contractility. Conclusion: Apical rotation and torsion were decreased in ST-elevation MI, and this was statistically significant in patients with LV dysfunction. VL - 7 IS - 6 ER -
Information
Email: