AIMS: Speckle-tracking echocardiography (STE) has emerged as a quantitative technique to assess left ventricular (LV) function via twist mechanics. Hypertension-associated changes in LV twist have not been previously evaluated in African patients with LV systolic dysfunction. This study evaluates LV twist dynamics in hypertensive patients with a low ejection fraction (EF). METHODS AND RESULTS: Forty-one hypertensive patients with EF <45% and normal coronary angiography (HTLEF group) were compared with 41 control subjects using STE. Peak apical rotation (AR) and isochronous basal rotation (BR) were measured, as was net twist (maximal value of simultaneous AR-BR). Rigid body rotation (RBR) was defined as AR and BR occurring in the same direction. Of 41 HTLEF patients, 28 (68%) had normal twist pattern, whereas 13 (32%) exhibited RBR; 11 of those 13 exhibited clockwise rotation. AR (1.89° ± 0.99 vs. 7.15° ± 2.26; P < 0.0001), BR (1.44° ± 0.78 vs. -3.75° ± 1.61; P < 0.0001), and net twist (3.3° ± 1.17 vs. 10.9° ± 2.7; P < 0.0001) were lower in HTLEF patients. The subgroup with clockwise RBR showed greater LV dysfunction (EF: 27.9 ± 5.8 vs. 35 ± 7.5%; P = 0.005) and more spherical LV geometry in both diastole and systole (P = 0.0009 and P = 0.0002, respectively) compared with those who had a normal pattern of twist. In the HTLEF subgroup with normal twist pattern, AR (r = 0.57; P = 0.002) and net twist (r = 0.57; P = 0.002) correlated with EF. CONCLUSIONS: LV twist in patients with hypertension and EF <45% is diminished. Apical rotation and net twist are good correlates for EF in hypertensive patients with EF <45%.
AIMS: Speckle-tracking echocardiography (STE) has emerged as a quantitative technique to assess left ventricular (LV) function via twist mechanics. Hypertension-associated changes in LV twist have not been previously evaluated in African patients with LV systolic dysfunction. This study evaluates LV twist dynamics in hypertensivepatients with a low ejection fraction (EF). METHODS AND RESULTS: Forty-one hypertensivepatients with EF <45% and normal coronary angiography (HTLEF group) were compared with 41 control subjects using STE. Peak apical rotation (AR) and isochronous basal rotation (BR) were measured, as was net twist (maximal value of simultaneous AR-BR). Rigid body rotation (RBR) was defined as AR and BR occurring in the same direction. Of 41 HTLEF patients, 28 (68%) had normal twist pattern, whereas 13 (32%) exhibited RBR; 11 of those 13 exhibited clockwise rotation. AR (1.89° ± 0.99 vs. 7.15° ± 2.26; P < 0.0001), BR (1.44° ± 0.78 vs. -3.75° ± 1.61; P < 0.0001), and net twist (3.3° ± 1.17 vs. 10.9° ± 2.7; P < 0.0001) were lower in HTLEF patients. The subgroup with clockwise RBR showed greater LV dysfunction (EF: 27.9 ± 5.8 vs. 35 ± 7.5%; P = 0.005) and more spherical LV geometry in both diastole and systole (P = 0.0009 and P = 0.0002, respectively) compared with those who had a normal pattern of twist. In the HTLEF subgroup with normal twist pattern, AR (r = 0.57; P = 0.002) and net twist (r = 0.57; P = 0.002) correlated with EF. CONCLUSIONS: LV twist in patients with hypertension and EF <45% is diminished. Apical rotation and net twist are good correlates for EF in hypertensivepatients with EF <45%.
Authors: Attila Nemes; Gergely Rácz; Árpád Kormányos; Péter Domsik; Anita Kalapos; Nándor Gyenes; Nóra Ambrus; István Hartyánszky; Gábor Bogáts; Kálmán Havasi Journal: Cardiovasc Diagn Ther Date: 2021-04
Authors: Marcelo Dantas Tavares de Melo; Jose de Arimatéia Batista Araujo-Filho; José Raimundo Barbosa; Camila Rocon; Carlos Danilo Miranda Regis; Alex Dos Santos Felix; Roberto Kalil Filho; Edimar Alcides Bocchi; Ludhmila Abrahão Hajjar; Mahdi Tabassian; Jan D'hooge; Vera Maria Cury Salemi Journal: PLoS One Date: 2021-11-29 Impact factor: 3.240