Left ventricular torsional dynamics in aortic stenosis: relationship between left ventricular untwisting and filling pressures. A two-dimensional speckle tracking study.

Popescu, Bogdan Alexandru; Calin, Andreea; Beladan, Carmen C.; Muraru, Denisa; Rosca, Monica; Deleanu, Dan; LANCELLOTTI, Patrizio; Antonini-Canterin, Francesco; Nicolosi, Gian Luigi; Ginghina, Carmen

doi:10.1093/ejechocard/jep224

Article (Scientific journals)

Left ventricular torsional dynamics in aortic stenosis: relationship between left ventricular untwisting and filling pressures. A two-dimensional speckle tracking study.

Popescu, Bogdan Alexandru; Calin, Andreea; Beladan, Carmen C. et al.

2010 • In European Journal of Echocardiography, 11 (5), p. 406-13

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/151015

DOI
10.1093/ejechocard/jep224

PubMed
20053657

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Keywords :

Aged; Analysis of Variance; Aortic Valve Stenosis/pathology/ultrasonography; Case-Control Studies; Diastole; Echocardiography/methods; Female; Heart Ventricles/pathology/ultrasonography; Humans; Male; Middle Aged; Natriuretic Peptide, Brain/blood; Prognosis; Prospective Studies; Regression Analysis; Severity of Illness Index; Statistics as Topic; Stroke Volume; Torsion, Mechanical; Ventricular Dysfunction, Left/pathology/ultrasonography; Ventricular Function, Left/physiology; Ventricular Pressure/physiology

Abstract :

[en] AIMS: The contribution of left ventricular (LV) untwisting to LV suction and early-diastolic filling was previously demonstrated, but this was not yet tested in patients with aortic stenosis (AS). We sought to assess the relationship between LV untwisting and LV filling pressures in patients with severe AS and normal left ventricular ejection fraction (LVEF) using speckle tracking echocardiography. METHODS AND RESULTS: Sixty-one consecutive patients (66 +/- 9 years) with severe AS, preserved LVEF (63 +/- 6%), and 40 normal subjects (47 +/- 12 years) were prospectively enrolled. A comprehensive echocardiographic examination was performed in all. LV rotation and twisting were assessed using speckle tracking echocardiography. Peak apical back rotation rate, peak LV untwisting rate, and time intervals from QRS onset (ECG) to each of them were measured. Brain natriuretic peptide (BNP) levels were determined in 30 patients. Patients with AS were older than normal subjects (P < 0.001). LV mass, LA volume, LV filling pressures as well as peak apical back rotation rate and time to peak apical back rotation rate were increased in patients (P < 0.05 for all). In patients with AS, both time to peak LV untwisting rate and time to peak apical back rotation rate were significantly related to E/E' ratio and to BNP levels (P < 0.04 for all). CONCLUSION: In patients with severe AS and preserved LVEF, there is a significant relationship between LV untwisting and LV filling pressures, suggesting a role for impaired LV untwisting in the pathophysiology of diastolic dysfunction in this setting.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Popescu, Bogdan Alexandru

Calin, Andreea

Beladan, Carmen C.

Muraru, Denisa

Rosca, Monica

Deleanu, Dan

LANCELLOTTI, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > Cardiologie

Antonini-Canterin, Francesco

Nicolosi, Gian Luigi

Ginghina, Carmen

Language :

English

Title :

Left ventricular torsional dynamics in aortic stenosis: relationship between left ventricular untwisting and filling pressures. A two-dimensional speckle tracking study.

Publication date :

2010

Journal title :

European Journal of Echocardiography

ISSN :

1525-2167

eISSN :

1532-2114

Publisher :

W. B. Saunders Co., United Kingdom

Volume :

Issue :

Pages :

406-13

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 21 June 2013

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