Twist Mechanics of the Left Ventricle: Principles and Application
TLDR
An algorithm for routine application of LV twist in clinical differentiation of patterns of LV dysfunction encountered in day-to-day practice is presented and variations in LV twist encountered in different experimental and clinical situations are discussed.Abstract:
Left ventricular (LV) twist or torsion represents the mean longitudinal gradient of the net difference in clockwise and counterclockwise rotation of the LV apex and base, as viewed from LV apex. Twist during ejection predominantly deforms the subendocardial fiber matrix, resulting in storage of potential energy. Subsequent recoil of twist deformation is associated with the release of restoring forces, which contributes to LV diastolic relaxation and early diastolic filling. Noninvasive techniques such as magnetic resonance imaging and echocardiography are useful for understanding LV twist dynamics in clinical settings, and data regarding their relative merits and pitfalls are rapidly accumulating. This review is a focused update on the current and evolving applications of LV twist mechanics in clinical cardiology. First, the theoretical framework for understanding the physiological sequence of LV twist during a cardiac cycle is presented. Second, variations in LV twist encountered in different experimental and clinical situations are discussed. Finally, the review presents an algorithm for routine application of LV twist in clinical differentiation of patterns of LV dysfunction encountered in day-to-day practice.read more
Citations
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Journal ArticleDOI
Cardiac Rotational Mechanics As a Predictor of Myocardial Recovery in Heart Failure Patients Undergoing Chronic Mechanical Circulatory Support: A Pilot Study
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 Adamopoulos,James C. Fang,Craig H. Selzman,Jeroen J. Bax,Stavros G. Drakos,Stavros G. Drakos,Stavros G. Drakos +17 more
TL;DR: LV rotational mechanics seem to be useful in selecting patients prone to cardiac recovery after mechanical unloading induced by LVADs, and future studies should investigate the utility of these markers in predicting durable heart recovery after the explantation of the cardiac assist device.
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Left ventricular energetics: new insight into the plasticity of regional contributions at rest and during exercise.
TL;DR: Findings provide unique insight into human LV function by demonstrating that within this functional syncytium, significant differences in the regional contributions of kinetic energy to overall LV work exist and the underpinning LV wall energetics adjust according to the prevailing cardiovascular demand.
Journal ArticleDOI
Correlations between echocardiographic aortic elastic properties and left ventricular rotation and twist – Insights from the three‐dimensional speckle‐tracking echocardiographic MAGYAR‐Healthy Study
TL;DR: The current study was designed to evaluate correlations between echocardiographic aortic elastic properties and LV rotational mechanics in healthy subjects.
Journal ArticleDOI
Effect of Age on Left Ventricular Global Dyssynchrony in Asymptomatic Individuals: A Population Study
TL;DR: This study investigated the effect of age on t‐IVT and Tei index, which are sensitive indexes of global ventricular dyssynchrony in patients with heart failure or myocardial activation abnormalities.
Journal ArticleDOI
Left ventricular shape and mass impact torsional dynamics in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction.
Roxana Enache,Bogdan A. Popescu,Rita Piazza,Denisa Muraru,Andreea Calin,Carmen C. Beladan,Monica Rosca,Gian Luigi Nicolosi,Carmen Ginghina +8 more
TL;DR: LV apical rotation and torsion are decreased and LV twist is delayed in patients with chronic AR and normal LVEF, detecting early subclinical LV dysfunction before LVEf declines.
References
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Journal ArticleDOI
Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging
Yuichi Notomi,Peter Lysyansky,Randolph M. Setser,Takahiro Shiota,Zoran B. Popović,Maureen G. Martin-Miklovic,Joan A. Weaver,Stephanie J. Oryszak,Neil L. Greenberg,Richard D. White,James D. Thomas +10 more
TL;DR: The STI estimation of LVtor is concordant with those analyzed by tagged MRI and also showed good agreement with those by DTI (data derived from tissue velocity) and may make the assessment more available in clinical and research cardiology.
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New Noninvasive Method for Assessment of Left Ventricular Rotation Speckle Tracking Echocardiography
Thomas Helle-Valle,Jonas Crosby,Thor Edvardsen,Erik Lyseggen,Brage Amundsen,Hans-Jørgen Smith,Boaz D. Rosen,João A. C. Lima,Hans Torp,Halfdan Ihlen,Otto A. Smiseth +10 more
TL;DR: It is demonstrated that regional LV rotation and torsion can be measured accurately by STE, suggesting a new echocardiographic approach for quantification of LV systolic function.
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Left ventricular structure and function: basic science for cardiac imaging.
Partho P. Sengupta,Josef Korinek,Marek Belohlavek,Jagat Narula,Mani A. Vannan,Arshad Jahangir,Bijoy K. Khandheria +6 more
TL;DR: The myofiber geometry of the left ventricle (LV) changes gradually from a right-handed helix in the subendocardium to a left-handed one in subepicardium as mentioned in this paper, and the link between LV deformation and the intracavitary flow direction observed during each phase of the cardiac cycle.
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Three-dimensional left ventricular deformation in hypertrophic cardiomyopathy.
TL;DR: HCM patients had reduced 3D myocardial shortening on a regional basis; however, LV torsion was increased, and the principal strain associated with 3D maximal contraction was slightly depressed in many regions.
Journal ArticleDOI
Enhanced ventricular untwisting during exercise: a mechanistic manifestation of elastic recoil described by Doppler tissue imaging.
Yuichi Notomi,Maureen G. Martin-Miklovic,Stephanie J. Oryszak,Takahiro Shiota,Dimitri Deserranno,Zoran B. Popović,Mario J. Garcia,Neil L. Greenberg,James D. Thomas +8 more
TL;DR: LV torsion and subsequent rapid untwisting appear to be manifestations of elastic recoil, critically linking systolic contraction to diastolic filling, which may assist efficient LV filling, an effect that appears blunted in HCM.