AIMS: Decreased left ventricular (LV) rotation and torsion and even reversed systolic apical rotation have been described in patients with dilated cardiomyopathy (DCM). We sought to test in patients with DCM whether reversed apical rotation with loss of LV torsion is related to the extent of LV remodelling and to the severity of LV dysfunction. METHODS AND RESULTS: Fifty consecutive patients with DCM (aged 49 +/- 13 years) were enrolled prospectively. Forty-seven healthy volunteers served as controls. All subjects underwent clinical examination, 12-lead electrocardiography, and a comprehensive echocardiogram. Basal and apical LV rotation and LV torsion were quantified by speckle tracking echocardiography. Left ventricular systolic rotation and torsion were reduced in patients, compared with controls (P < 0.001). Normally directed (counterclockwise) apical rotation was found in 24 patients (group 1), whereas 26 had reversed (clockwise) apical rotation (group 2). Patients in group 2 had larger LV volume, increased LV sphericity (P < or = 0.02), more severe systolic dysfunction (ejection fraction 26 +/- 7 vs. 33 +/- 12%), and higher filling pressures (E/E' ratio 19 +/- 10 vs. 14 +/- 6; P < 0.05). The main correlates of LV apical rotation were LV volume, sphericity index, and QRS duration. CONCLUSION: Reversed apical rotation and loss of LV torsion in patients with DCM is associated with significant LV remodelling, increased electrical dyssynchrony, reduced systolic function, and increased filling pressures, indicating a more advanced disease stage.
AIMS: Decreased left ventricular (LV) rotation and torsion and even reversed systolic apical rotation have been described in patients with dilated cardiomyopathy (DCM). We sought to test in patients with DCM whether reversed apical rotation with loss of LV torsion is related to the extent of LV remodelling and to the severity of LV dysfunction. METHODS AND RESULTS: Fifty consecutive patients with DCM (aged 49 +/- 13 years) were enrolled prospectively. Forty-seven healthy volunteers served as controls. All subjects underwent clinical examination, 12-lead electrocardiography, and a comprehensive echocardiogram. Basal and apical LV rotation and LV torsion were quantified by speckle tracking echocardiography. Left ventricular systolic rotation and torsion were reduced in patients, compared with controls (P < 0.001). Normally directed (counterclockwise) apical rotation was found in 24 patients (group 1), whereas 26 had reversed (clockwise) apical rotation (group 2). Patients in group 2 had larger LV volume, increased LV sphericity (P < or = 0.02), more severe systolic dysfunction (ejection fraction 26 +/- 7 vs. 33 +/- 12%), and higher filling pressures (E/E' ratio 19 +/- 10 vs. 14 +/- 6; P < 0.05). The main correlates of LV apical rotation were LV volume, sphericity index, and QRS duration. CONCLUSION: Reversed apical rotation and loss of LV torsion in patients with DCM is associated with significant LV remodelling, increased electrical dyssynchrony, reduced systolic function, and increased filling pressures, indicating a more advanced disease stage.
Authors: Michael J Bonios; Antigone Koliopoulou; Omar Wever-Pinzon; Iosif Taleb; Josef Stehlik; Weining Xu; James Wever-Pinzon; Anna Catino; Abdallah G Kfoury; Benjamin D Horne; Jose Nativi-Nicolau; Stamatis N Adamopoulos; James C Fang; Craig H Selzman; Jeroen J Bax; Stavros G Drakos Journal: Circ Cardiovasc Imaging Date: 2018-04 Impact factor: 7.792
Authors: Roxana Enache; Bogdan A Popescu; Rita Piazza; Denisa Muraru; Andreea Călin; Carmen C Beladan; Monica Roşca; Gian Luigi Nicolosi; Carmen Ginghină Journal: Int J Cardiovasc Imaging Date: 2015-05-21 Impact factor: 2.357
Authors: Michael Huntgeburth; Ingo Germund; Lianne M Geerdink; Narayanswami Sreeram; Floris E A Udink Ten Cate Journal: Cardiovasc Diagn Ther Date: 2019-10