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Age-related Changes in the Left Ventricular Twist

Year 2017, Volume: 20 Issue: 2, 125 - 129, 01.08.2017

Abstract

Introduction:
Left
ventricular (LV) rotation and twist play important roles in LV contraction and
relaxation. Systolic function is usually preserved with aging, but diastolic
function deteriorates. The aim of this study was to establish a reference value
for LV twist and examine the effect of aging on it.



Patients
and Methods:
We enrolled 75 healthy subjects who were divided into
two groups according to age: < 40 and > 40 years. LV rotation and twist
were assessed with two-dimensional speckle tracking imaging at the basal and
apical levels of the parasternal short axis. LV twist was defined as an apical
rotation relative to the baseline. Exclusion criteria included a history of
ischemic and valvular disease, arrhythmia, use of a pacemaker, and systolic
dysfunction.



Results: Peak A
wave velocity (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001) and E/E’ratio (7.7 ±
2.2 vs. 6.1 ± 1.3, p< 0.001) were higher and peak E wave velocity (52.4 ± 16
vs. 76.8 ± 11, p< 0.001) and E/A ratio (0.75 vs. 1.34, p< 0.001) were
lower in old patients than in young patients. There was an increase in apical
rotation (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) and a decrease in basal rotation
(−4.1 ± 2.7° vs. −5.2 ± 3.7°, p= 0.185) in old patients, but these changes
indicated no significant difference. With aging, the twist increased (8.6 ±
3.3° vs. 8.5 ± 4.1°, p= 0.890), but not significantly. LV apical rotation (5 ±
3.2 vs. 2.4 ± 1.1, p= 0.004) and twist (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64)
decreased in the old group with an increasing degree of LV diastolic
dysfunction.



Conclusion: LV twist slightly increased
with age, but this effect was reversed with increased diastolic dysfunction
even in the presence of normal systolic function.

References

  • 1. Hollingsworth KG, Blamire AM, Keavney BD, Macgowan GA. Left ventricular torsion, energetics, and diastolic function in normal human aging. Am J Physiol Heart Circ Physiol 2012;302:885-92.
  • 2. Cameli M, Lisi M, Righini FM, Massoni A, Mondillo S. Left ventricular remodeling and torsion dynamics in hypertensive patients. Int J Cardiovasc Imaging 2013;29:7986.
  • 3. Lamia B, Tanabe M, Tanaka H, Kim HK, Gorcsan J, Pinsky MR. Left ventricular systolic torsion correlates global cardiac performance during dyssynchrony and cardiac resynchronization therapy. Am J Physiol Heart Circ Physiol 2011;300:853-8.
  • 4. Notomi Y, Srinath G, Shiota T, Martin-Miklovic MG, Beachler L, Howell K, et al. Maturational and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. J Am Coll Cardiol 2006;113:2534-41.
  • 5. Cameli M, Ballo P, Righini FM, Caputo M, Lisi M, Mondillo S. Physiologic determinants of left ventricular systolic torsion assessed by speckle tracking echocardiography in healthy subjects. Echocardiography 2011;28:641-8.
  • 6. Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, Patel K, et al. The pathophysiology of heart failure with normal ejection fraction: exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion. J Am CollCardiol 2009;54:36-46.
  • 7. Saygısunar U, Kılıç H, Aytürk M, Karagöz A, Gökhan Vural M, Aksoy M, et al. Volume depletion provided by blood donation alters twist mechanics of the heart. Scand Cardiovasc J 2016;50:23-7.
  • 8. Russel IK, Gotte MJ, Bronzwaer JG, Knaapen P, Paulus WJ, van Rossum AC. Left ventricular torsion: an expanding role in the analysis of myocardial dysfunction. JACC Cardiovasc Imaging 2009;2:648-55.
  • 9. Grabskaya E, Spira C, Hoffmann R, Altiok E, Ocklenburg C, Hoffmann R, et al. Myocardial rotation but not circumferential strain is transducer angle dependent: a speckle tracking echocardiography study. Echocardiography 2010;27:809-14.
  • 10. Sengupta PP, Tajik AJ, Chandrasekaran K, Khandheria BK. Twist mechanics of the left ventricle: principles and application. JACC Cardiovasc Imaging 2008;1:366-76.
  • 11. Sohn DW, Chai IH, Lee DJ, Kim HC, Kim HS, Oh BH, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997;30:474-80.
  • 12. Kim HK, Sohn DW, Lee SE, Choi SY, Park JS, Kim YJ, et al. Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 2007;20:45-53.
  • 13. Nakai H, Takeuchi M, Nishikage T, Kokumai M, Otani S, Lang RM. Effect of aging on twist-displacement loop by 2- dimensional speckle tracking imaging. J Am Soc Echocardiography 2006;19:880-5.
  • 14. 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;112:3149-56.
  • 15. Notomi Y, Lysyansky P, Setser RM, Shiota T, Popovic ZB, Martin- Miklovic MG, et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 2005;45:2034-41.
  • 16. Nagel E, Stuber M, Burkhard B, Fischer SE, Scheidegger MB, Boesiger P, et al. Cardiac rotation and relaxation in patients with aortic valve stenosis. Eur Heart J 2000;21:582-9.
  • 17. Tadic M, Cuspidi C, Majstorovic A, Kocijancic V, Celic V. The relationship between left ventricular deformation and different geometric patterns according to the updated classification: findings from the hypertensive population. J Hypertens 2015;33:1954-61.
  • 18. Sandstede JJ, Johnson T, Harre K, Beer M, Hofmann S, Pabst T, et al. Cardiac systolic rotation and contraction before and after valve replacement for aortic stenosis: a myocardial tagging study using MR imaging. AJR Am J Roentgenol 2002;178:953-8.
  • 19. Takeuchi M, Nakai H, Kokumai M, Nishikage T, Otani S, Lang RM. Age-related changes in left ventricular twist assessed by twodimensional speckle-tracking imaging. J Am Soc Echocardiogr 2006;19:1077-84.
  • 20. Sun JP, Lam YY, Wu CQ, Yang XS, Guo R, Kwong JS, et al. Effect of age and gender on left ventricular rotation and twist in a large group of normal adults: a multicenter study. Int J Cardiol 2013;167:2215-21.
  • 21. Zhang Y, Zhou QC, Pu D, Zou L, Tan Y. Differences in left ventricular twist related to age: speckle tracking echocardiographic data for healthy volunteers from neonate to age 70 years. Echocardiography 2010;27:1205-10.
  • 22. Lee HJ, Kim BS, Kim JH, Jang HS, Bae BS, Kang HJ, et al. Age-related changes in left ventricular torsion as assessed by 2-dimensional ultrasound speckle tracking imaging. Korean Circ J 2008;38:529-35.
  • 23. Maufrais C, Schuster I, Doucende G, Vitiello D, Rupp T, Dauzat M, et al. Endurance training minimizes age-related changes of left ventricular twist-untwist mechanics. J Am Soc Echocardiogr 2014;27:1208-15.
  • 24. Pagourelias ED, Sotiriou P, Papadopoulos CE, Cholongitas E, Giouleme O, Vassilikos V. Left ventricular myocardial mechanics in cirrhosis: a speckle tracking echocardiographic study. Echocardiography 2016;33:223-32.
  • 25. Enache R, Popescu BA, Piazza R, Muraru D, Câlin A, Beladan CC, et al. Left ventricular shape and mass impact torsional dynamics in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction. Int J Cardiovasc Imaging 2015;31:1315-26.

Sol Ventrikül Bükülme Hareketinde Yaşa Bağlı Değişiklikler

Year 2017, Volume: 20 Issue: 2, 125 - 129, 01.08.2017

Abstract

Giriş: Sol ventrikül (LV) rotasyon ve büküm hareketi kasılma ve
gevşemede önemli rol oynamaktadır. Yaşlanma ile LV sistolik fonksiyonları
korunsada diyastolik fonksiyonlar genellikle bozulur. Bu çalışmanın amacı, LV
büküm için bir referans değeri saptamak ve yaşlanmanın büküm üzerinde
etkilerini incelemekti.



Hastalar ve Yöntem: Çalışmaya 75 sağlıklı kişi
dahil edildi; katılımcılar 40 yaş üstü ve 40 yaş altı olarak iki gruba ayrıldı.
LV rotasyon ve büküm parasternal kısa eksen bazal ve apikal seviyelerinde 2D-STI
ile değerlendirildi. LV büküm hareketi apikal ve bazal rotasyonun göreceli
toplamı olarak tanımlandı. İskemik ve kapak hastalığı, aritmi, kalp pili ve
sistolik disfonksiyon öyküsü dışlama kriterleri olarak tanımlandı. 



Bulgular: Yaşlılarda gençlere kıyasla pik A dalga hızı (70.6 ±
13.7 vs. 57.7 ± 10.6, p< 0.001), E/E’ oranı (7.7 ± 2.23 vs. 6.09 ± 1.3,
p< 0.001) daha yüksek, pik E dalga hızı (52.4 ± 16 vs. 76.75 ± 11, p<
0.001), E/A oranı (0.75 vs. 1.34, p< 0.001) daha düşüktü. Yaşlı grupta
apikal rotasyonda artış (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) ve bazal
rotasyonda azalma (-4.1 ± 2.7° vs. 3.7°± -5.2, p= 0.185) izlendi ancak, bu
değişiklikler anlamlı değildi. Yaşlanma ile birlikte, büküm önemsiz derecede
arttı (8.6 ± 3.3° vs. 8.53 ± 4.1°, p= 0.890). Yaşlı grupta LV diyastolik
disfonksiyon derecesi arttıkça apikal rotasyon (5.02 ± 3.2 vs. 2.4 ± 1.1, p=
0.004) ve büküm (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) azaldı.



Sonuç: Bu çalışma LV bükümün
yaşla birlikte hafifçe arttığını, ancak bu etkinin sistolik fonksiyonları
normal olsada artmış diyastolik disfonksiyon varlığında tersine döndüğünü
gösterdi.

References

  • 1. Hollingsworth KG, Blamire AM, Keavney BD, Macgowan GA. Left ventricular torsion, energetics, and diastolic function in normal human aging. Am J Physiol Heart Circ Physiol 2012;302:885-92.
  • 2. Cameli M, Lisi M, Righini FM, Massoni A, Mondillo S. Left ventricular remodeling and torsion dynamics in hypertensive patients. Int J Cardiovasc Imaging 2013;29:7986.
  • 3. Lamia B, Tanabe M, Tanaka H, Kim HK, Gorcsan J, Pinsky MR. Left ventricular systolic torsion correlates global cardiac performance during dyssynchrony and cardiac resynchronization therapy. Am J Physiol Heart Circ Physiol 2011;300:853-8.
  • 4. Notomi Y, Srinath G, Shiota T, Martin-Miklovic MG, Beachler L, Howell K, et al. Maturational and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. J Am Coll Cardiol 2006;113:2534-41.
  • 5. Cameli M, Ballo P, Righini FM, Caputo M, Lisi M, Mondillo S. Physiologic determinants of left ventricular systolic torsion assessed by speckle tracking echocardiography in healthy subjects. Echocardiography 2011;28:641-8.
  • 6. Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, Patel K, et al. The pathophysiology of heart failure with normal ejection fraction: exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion. J Am CollCardiol 2009;54:36-46.
  • 7. Saygısunar U, Kılıç H, Aytürk M, Karagöz A, Gökhan Vural M, Aksoy M, et al. Volume depletion provided by blood donation alters twist mechanics of the heart. Scand Cardiovasc J 2016;50:23-7.
  • 8. Russel IK, Gotte MJ, Bronzwaer JG, Knaapen P, Paulus WJ, van Rossum AC. Left ventricular torsion: an expanding role in the analysis of myocardial dysfunction. JACC Cardiovasc Imaging 2009;2:648-55.
  • 9. Grabskaya E, Spira C, Hoffmann R, Altiok E, Ocklenburg C, Hoffmann R, et al. Myocardial rotation but not circumferential strain is transducer angle dependent: a speckle tracking echocardiography study. Echocardiography 2010;27:809-14.
  • 10. Sengupta PP, Tajik AJ, Chandrasekaran K, Khandheria BK. Twist mechanics of the left ventricle: principles and application. JACC Cardiovasc Imaging 2008;1:366-76.
  • 11. Sohn DW, Chai IH, Lee DJ, Kim HC, Kim HS, Oh BH, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997;30:474-80.
  • 12. Kim HK, Sohn DW, Lee SE, Choi SY, Park JS, Kim YJ, et al. Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 2007;20:45-53.
  • 13. Nakai H, Takeuchi M, Nishikage T, Kokumai M, Otani S, Lang RM. Effect of aging on twist-displacement loop by 2- dimensional speckle tracking imaging. J Am Soc Echocardiography 2006;19:880-5.
  • 14. 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;112:3149-56.
  • 15. Notomi Y, Lysyansky P, Setser RM, Shiota T, Popovic ZB, Martin- Miklovic MG, et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 2005;45:2034-41.
  • 16. Nagel E, Stuber M, Burkhard B, Fischer SE, Scheidegger MB, Boesiger P, et al. Cardiac rotation and relaxation in patients with aortic valve stenosis. Eur Heart J 2000;21:582-9.
  • 17. Tadic M, Cuspidi C, Majstorovic A, Kocijancic V, Celic V. The relationship between left ventricular deformation and different geometric patterns according to the updated classification: findings from the hypertensive population. J Hypertens 2015;33:1954-61.
  • 18. Sandstede JJ, Johnson T, Harre K, Beer M, Hofmann S, Pabst T, et al. Cardiac systolic rotation and contraction before and after valve replacement for aortic stenosis: a myocardial tagging study using MR imaging. AJR Am J Roentgenol 2002;178:953-8.
  • 19. Takeuchi M, Nakai H, Kokumai M, Nishikage T, Otani S, Lang RM. Age-related changes in left ventricular twist assessed by twodimensional speckle-tracking imaging. J Am Soc Echocardiogr 2006;19:1077-84.
  • 20. Sun JP, Lam YY, Wu CQ, Yang XS, Guo R, Kwong JS, et al. Effect of age and gender on left ventricular rotation and twist in a large group of normal adults: a multicenter study. Int J Cardiol 2013;167:2215-21.
  • 21. Zhang Y, Zhou QC, Pu D, Zou L, Tan Y. Differences in left ventricular twist related to age: speckle tracking echocardiographic data for healthy volunteers from neonate to age 70 years. Echocardiography 2010;27:1205-10.
  • 22. Lee HJ, Kim BS, Kim JH, Jang HS, Bae BS, Kang HJ, et al. Age-related changes in left ventricular torsion as assessed by 2-dimensional ultrasound speckle tracking imaging. Korean Circ J 2008;38:529-35.
  • 23. Maufrais C, Schuster I, Doucende G, Vitiello D, Rupp T, Dauzat M, et al. Endurance training minimizes age-related changes of left ventricular twist-untwist mechanics. J Am Soc Echocardiogr 2014;27:1208-15.
  • 24. Pagourelias ED, Sotiriou P, Papadopoulos CE, Cholongitas E, Giouleme O, Vassilikos V. Left ventricular myocardial mechanics in cirrhosis: a speckle tracking echocardiographic study. Echocardiography 2016;33:223-32.
  • 25. Enache R, Popescu BA, Piazza R, Muraru D, Câlin A, Beladan CC, et al. Left ventricular shape and mass impact torsional dynamics in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction. Int J Cardiovasc Imaging 2015;31:1315-26.
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Investigations
Authors

Sabiye Yılmaz

Harun Kılıç This is me

Saadet Demirtaş This is me

Mehmet Bülent Vatan This is me

Efe Edem This is me

Mustafa Tarık Ağaç This is me

Mustafa Türker Pabuccu This is me

Mehmet Akif Çakar This is me

Mustafa Gökhan Vural This is me

Murat Aksoy This is me

Ersan Tatlı This is me

Hüseyin Gündüz This is me

Ramazan Akdemir This is me

Publication Date August 1, 2017
Published in Issue Year 2017 Volume: 20 Issue: 2

Cite

Vancouver Yılmaz S, Kılıç H, Demirtaş S, Vatan MB, Edem E, Ağaç MT, Türker Pabuccu M, Çakar MA, Vural MG, Aksoy M, Tatlı E, Gündüz H, Akdemir R. Age-related Changes in the Left Ventricular Twist. Koşuyolu Heart Journal. 2017;20(2):125-9.