Influence of cardiac shape on left ventricular twist

• Published in: Journal of applied physiology (1985) Vol. 108; no. 1; pp. 146 - 151
• Main Authors: van Dalen, Bas M, Kauer, Floris, Vletter, Wim B, Soliman, Osama I. I, van der Zwaan, Heleen B, ten Cate, Folkert J, Geleijnse, Marcel L
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Am Physiological Soc 01.01.2010; American Physiological Society
• Subjects: Adult; Biological and medical sciences; Cardiomyopathy, Dilated - complications; Cardiomyopathy, Dilated - diagnostic imaging; Cardiomyopathy, Dilated - physiopathology; Female; Fundamental and applied biological sciences. Psychology; Heart; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Multivariate analysis; Stroke Volume; Studies; Ultrasonic imaging; Ultrasonography; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology; Vertebrata; Echocardiography; Mammalia; Dilated cardiomyopathy; cardiac mechanics; Heart disease; Cardiovascular disease; cardiac function; Myocardial disease; left ventricular twist
• ISSN: 8750-7587; 1522-1601
• DOI: 10.1152/japplphysiol.00419.2009

Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands Submitted 22 April 2009 ; accepted in final form 20 October 2009 The dynamic interaction between subendocardial and subepicardial fibre helices in the left ventricle (LV) leads to a twisting deformation, which has an important role in LV function. This study sought to assess the influence of cardiac shape on LV twist in the normal and dilated human heart. The study comprised 45 dilated cardiomyopathy (DCM) patients and 60 for age- and gender-matched healthy volunteers. Speckle tracking echocardiography was used to determine basal and apical LV peak systolic rotation (Rot max ) and instantaneous LV peak systolic twist (Twist max ). LV sphericity index was calculated by dividing the LV maximal long-axis internal dimension by the maximal short-axis internal dimension at end-diastole. A parabolic relation between the sphericity index and apical Rot max or Twist max was identified in the total study population ( R 2 = 0.56 and R 2 = 0.54, respectively; both P < 0.001) and healthy volunteers ( R 2 = 0.39 and R 2 = 0.25, respectively; both P < 0.001), whereas these relations were linear in DCM patients ( R 2 = 0.40 and R 2 = 0.43, respectively; both P < 0.001). In a multivariate analysis, LV sphericity index was the strongest independent predictor of apical Rot max and Twist max . In conclusion, LV apical rotation and twist are significantly influenced by LV configuration. Taking the important function of LV twist into account, this finding highlights the vital influence of cardiac shape on LV systolic function. cardiac mechanics; cardiac function; left ventricular twist; dilated cardiomyopathy; echocardiography Address for reprint requests and other correspondence: M. L. Geleijnse, Erasmus Univ. Medical Center, Thoraxcenter, Rm. BA 302, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands (e-mail: m.geleijnse{at}erasmusmc.nl ).