American Journal of Cardiology
Volume 103, Issue 11 , Pages 1506-1512, 1 June 2009

Left Ventricular Rotational Mechanics in Acute Myocardial Infarction and in Chronic (Ischemic and Nonischemic) Heart Failure Patients

  • Matteo Bertini, MD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • Department of Cardiology, University of Bologna, Bologna, Italy
    • Drs. Matteo Bertini and Gaetano Nucifora contributed equally to this article.
    • ,
  • Gaetano Nucifora, MD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • Drs. Matteo Bertini and Gaetano Nucifora contributed equally to this article.
    • ,
  • Nina Ajmone Marsan, MD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Victoria Delgado, MD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Rutger J. van Bommel, MD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Giuseppe Boriani, MD, PhD

      Affiliations

    • Department of Cardiology, University of Bologna, Bologna, Italy
    • ,
  • Mauro Biffi, MD

      Affiliations

    • Department of Cardiology, University of Bologna, Bologna, Italy
    • ,
  • Eduard R. Holman, MD, PhD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Ernst E. Van der Wall, MD, PhD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Martin J. Schalij, MD, PhD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Jeroen J. Bax, MD, PhD

      Affiliations

    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
    • Corresponding Author InformationCorresponding author: Tel: 31-71-526-2020; fax: 31-71-526-6809

Received 5 December 2008; received in revised form 5 February 2009; accepted 5 February 2009. published online 10 April 2009.

Left ventricular (LV) twist and untwisting rate are emerging as global and thorough parameters for assessment of LV function. This study explored differences of LV twist and untwisting rate in patients with acute myocardial infarction (AMI) and patients with ischemic and nonischemic chronic heart failure (HF). Fifty patients with AMI, 49 with ischemic HF, and 38 with nonischemic HF were studied. As a control group, 28 subjects without evidence of structural heart disease were included. Speckle-tracking analysis was applied to LV short-axis images at basal and apical levels. LV twist was defined as the net difference of apical and basal rotations at isochronal time points. The first time derivative of LV untwist was defined as the LV untwisting rate. Compared with control subjects, peak LV twist was decreased in patients with AMI and extremely decreased in those with HF (p <0.001, analysis of variance). A strong correlation (r = 0.87, p <0.001) was found between peak LV twist and LV ejection fraction in the overall study population. LV untwisting rate was progressively decreased in patients with AMI and HF compared with control subjects (p <0.001, analysis of variance). A moderate correlation (r = 0.56, p <0.001) was noted between peak LV untwisting rate and grade of diastolic dysfunction in the overall study population. In conclusion, LV twist and untwisting rate are strongly related to LV systolic and diastolic functions, respectively. Impairment of LV function observed in patients with AMI and HF is associated with a decrease of LV twist and untwisting rate.

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 Gaetano Nucifora is financially supported by the Research Fellowship of the European Association of Percutaneous Cardiovascular Interventions, Sophia Antipolis, France. Nina Ajmone Marsan and Victoria Delgado are financially supported by the Research Fellowship of the European Society of Cardiology, Sophia Antipolis, France.Martin J. Schalij has research grants from Biotronik, Berlin, Germany; Boston Scientific, Natick, Massachusetts; and Medtronic, Minneapolis, Minnesota. Jeroen J. Bax has research grants from Biotronik, Berlin, Germany; BMS Medical Imaging, North Billerica, Massachusetts; Boston Scientific, Natick, Massachusetts; Edwards Lifesciences, Irvine, California; GE Healthcare, Buckinghamshire, United Kingdom; Medtronic, Minneapolis, Minnesota; and St. Jude Medical, St. Paul, Minnesota. The other authors have nothing to disclose.

PII: S0002-9149(09)00532-3

doi:10.1016/j.amjcard.2009.02.010

American Journal of Cardiology
Volume 103, Issue 11 , Pages 1506-1512, 1 June 2009

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