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• W2938756312 abstract "HomeCirculation: Cardiovascular ImagingVol. 12, No. 4Twist Mechanics of the Left Ventricle Free AccessEditorialPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessEditorialPDF/EPUBTwist Mechanics of the Left VentricleResearch Tool Today, Clinical Practice Tomorrow Luigi P. Badano, MD, PhD and Denisa Muraru, MD, PhD Luigi P. BadanoLuigi P. Badano Luigi P. Badano, MD, PhD, Istituto Auxologico Italiano, IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche e Metaboliche, Ospedale S. Luca, P.le Brescia 20, 20149 Milano, Italy. Email E-mail Address: [email protected] Istituto Auxologico Italiano, IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche, Metaboliche, Ospedale S. Luca, Milano, Italy. Search for more papers by this author and Denisa MuraruDenisa Muraru Istituto Auxologico Italiano, IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche, Metaboliche, Ospedale S. Luca, Milano, Italy. Search for more papers by this author Originally published12 Apr 2019https://doi.org/10.1161/CIRCIMAGING.119.009085Circulation: Cardiovascular Imaging. 2019;12:e009085This article is a commentary on the followingLeft Ventricular Twist Mechanics to Identify Left Ventricular Noncompaction in ChildhoodSee Article by Sabatino et alLeft ventricular (LV) function is determined by the complex interactions between myocardial tissue architecture, myocardial contractility, and loading conditions. Myocardial fibers within the LV wall present a double-helical arrangement that surrounds the circumferential fibers in the midwall.1 In the LV myocardial wall, the myofibers orientation changes gradually from a righthanded helix in the subendocardium to a lefthanded helix in the subepicardium, being almost horizontal in the midwall. This counter-directional helical arrangement of fiber layers also results in sliding or shear deformation.The contraction of subepicardial fibers will rotate the apex of the LV in counterclockwise and its base in clockwise direction. Conversely, the contraction of subendocardial fibers will rotate the LV apex and base in exactly the opposite directions. The larger radius of rotation for the outer epicardial layer produces higher torque and allows the subepicardial fibers to prevail in dominating the overall direction of rotation when both layers contract simultaneously1 and resulting in global counterclockwise LV rotation near the apex and clockwise rotation near the LV base during ejection.Functionally, this twist contributes to maintain a uniform distribution of LV fiber stress and fiber shortening across the wall,1 and to produce a relatively high ejection fraction (≈60%) despite limited (≈20%) myofiber shortening.1–5 Moreover, LV twisting and shearing of the subendocardial fibers during ejection deform the myocardial matrix and result in storage of potential energy, which is subsequently used for diastolic uncoiling of circumferential fibers and untwisting of helices, together producing diastolic suction.6 Thus, LV twist provides a key mechanistic link between systole and diastole. Both loading conditions and contractility alter the extent of LV twist.7–9 LV twist increases with higher preload (ie, higher end-diastolic LV volumes, with constant end-systolic volume, produce higher LV twist), and increasing contractility (eg,positive inotropic interventions such as dobutamine infusion and paired pacing). Conversely, an increase in afterload reduces LV twist.Several imaging modalities and techniques can be used to quantify LV twist mechanics: echocardiography (tissue Doppler, 2- and 3-dimensional speckle tracking, vector velocity imaging) cardiac magnetic resonance (tagging and phase contrast velocity mapping), and sonomicrometry. Currently, there is no gold standard for the assessment of LV twist mechanics, but the imaging modalities listed above have been compared against one another and show good agreement.10–12 Because of its safety, wide availability, cost/effectiveness and feasibility, echocardiography (namely, 2-dimensional speckle tracking echocardiography) has been the most frequently used imaging modality to assess LV twist mechanics in both normal subjects and patients with various cardiovascular diseases.13So far, LV twist parameters have been used mainly to study the changes in LV mechanics occurring in conditions characterized either by reduced (ischemic and dilated cardiomyopathy) or preserved (heart failure with preserved ejection fraction, hypertension, hypertrophic cardiomyopathy, aortic stenosis, aortic regurgitation, and mitral regurgitation) ejection fraction, as well as to identify myocardial dysfunction resulting from exposure to cancer therapeutics before detectable changes in LV ejection fraction may occur.14 However, the clinical utility of measuring any parameter related to LV mechanics in patients with cardiovascular disease include (1) identification of subclinical myocardial dysfunction, (2) provision of diagnostic and prognostic information, and (3) assessment of response to drug or device therapy. Because LV twist mechanics could not provide all this information for any specific cardiovascular disease state, its routine clinical use has been limited so far.In this issue of Circulation Cardiovascular Imaging, Sabatino et al15 reported the added clinical value of LV twist measurement to differentiate LV noncompaction, diagnosed using cardiac magnetic resonance, from the hypertrabeculated left ventricle in children (LV twist angle cutoff value <5.8°; sensitivity, 82%; specificity, 92%; AUC=0.914). Particularly, when the rigid body rotation pattern (a condition characterized by LV base and apex rotating in the same direction) was present (prevalence =56% in patients with LV noncompaction), the specificity to diagnose LV noncompaction raised to 99% (sensitivity =56%). Because LV noncompaction may represent 9% of all childhood cardiomyopathies16 and, in childhood16 but not in adults,17 outcomes for the dilated form of LVNC have been reported to be worse than those for dilated cardiomyopathy alone, the results obtained by Sabatino et al15 are clinically relevant. These results are particularly important because of the heterogeneity of LV noncompaction phenotypes and also the naturally trabeculated nature of the LV, which make the differential diagnosis challenging in a sizable number of patients. Moreover, this study is the first report of an added diagnostic value of LV twist over conventional echocardiography parameters. If these findings will be confirmed by others, LV twist measurement will become part of the clinical echocardiographic assessment of children with suspected LV noncompaction.However, despite the potential clinical importance of the results of this study, a word of caution is needed. In adults patients with LV noncompaction, Bellavia et al18 reported a reduction in systolic strain, strain rate, displacement, and rotation/torsion that was independent of ejection fraction similar to the findings by Sabatino et al.15 However, other studies have been both concordant19 and discordant20 with these findings, thereby casting doubt as to the discriminatory value of LV twist and torsion mechanics in the setting of LV noncompaction in adults. The discordant results may be because of the heterogeneity of LV noncompaction phenotypes, structural, and functional differences of the pediatric versus adult forms of LV noncompaction but may also depend on the technique itself that requires specific expertise in both image acquisition and postprocessing.To obtain LV twist mechanics using 2-dimensional speckle tracking echocardiography, we need 2 short-axis views from the LV base and apex. Data obtained from these views are postprocessed with dedicated software packages to construct LV twist mechanics curves characterizing the entire cardiac cycle. Although discrete anatomic landmarks of the LV base (ie, closed mitral valve during ventricular systole) facilitate standardization of this view, particular attention is required to ensure that full-thickness myocardium is imaged throughout the cardiac cycle to ensure that basal rotation can be tracked throughout the entire cardiac cycle. Accordingly, to account for the normal 12- to 15-mm systolic excursion of the LV base, the optimal basal LV short-axis view is the one with full-thickness myocardium surrounding the mitral valve at end systole. Conversely, standardization of the apical short-axis view is more challenging and more critical because the level of apical imaging plane acquisition has been shown to significantly affect the extent of apical rotation.21 Indeed, the LV apex is a sizable ventricular region with a wide range of rotation angles which spans from the distal papillary muscle insertion site to the densely trabeculated point of apical systolic obliteration. Unfortunately, in the LV apex, there is no unequivocal anatomic landmark to be used to standardize the level of the apical short-axis view. Conventionally, once the true apex is identified from an apical 4-chamber view, the transducer is moved to an upper intercostal space and tilted into the true short-axis plane, and the apical short-axis image is acquired as close to the true apex as possible, avoiding LV cavity obliteration during systole and keeping it as circular as possible. It is obvious that this approach is prone to large interpatient and test/retest variability. Finally, in addition to paying attention to the level of short-axis views, we need to acquire images with adequate temporal resolution (frame rate).1,14 Three-dimensional speckle tracking echocardiography has the potential to solve most of the problems of standardization of the location of the short-axis views, but the limited spatial and temporal resolution of the data sets acquired with current 3-dimensional echocardiography systems are insufficient to capture events occurring in fast phases of the cardiac cycle, such as isovolumic contraction and isovolumic relaxation.1,14Finally, image postprocessing is also critical to avoid overestimation or underestimation of LV twist mechanics: manual tracing of the endocardium needs to include all myocardial tissue but to exclude papillary muscle and trabeculations; the region of interest must cover the entire myocardium, from the endocardium to the epicardium (to account for layer-specific differences) but to exclude the relatively static pericardium; and, tracking of the myocardial segments throughout the cardiac cycle should be visually inspected and verified, avoiding to passively rely only on the tracking quality score inherent in most commercially available software packages.All these technical details are critical to obtain adequate, reproducible, and repeatable LV twist mechanic metrics. Because most of the acquisition and postprocessing steps are heavily operator dependent and difficult to standardize, we need precise standardization of LV data acquisition and raw data analysis, followed by large multicenter trials that can confirm the results obtained by Sabatino et al15 before the technique can enter the clinical routine.DisclosuresNone.FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.Luigi P. Badano, MD, PhD, Istituto Auxologico Italiano, IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche e Metaboliche, Ospedale S. Luca, P.le Brescia 20, 20149 Milano, Italy. Email [email protected]comReferences1. Omar AMS, Vallabhajosyula S, Sengupta PP. Left ventricular twist and torsion. Research observations and clinical applications.Circ Cardiovasc Imag. 2015; 8:e003029. doi: 10.1161/CIRCIMAGING.115.003029LinkGoogle Scholar2. Aelen FW, Arts T, Sanders DG, Thelissen GR, Muijtjens AM, Prinzen FW, Reneman RS. Relation between torsion and cross-sectional area change in the human left ventricle.J Biomech. 1997; 30:207–212.CrossrefMedlineGoogle Scholar3. Beyar R, Sideman S. A computer study of the left ventricular performance based on fiber structure, sarcomere dynamics, and transmural electrical propagation velocity.Circ Res. 1984; 55:358–375.LinkGoogle Scholar4. Beyar R, Sideman S. The dynamic twisting of the left ventricle: a computer study.Ann Biomed Eng. 1986; 14:547–562.CrossrefMedlineGoogle Scholar5. Vendelin M, Bovendeerd PH, Engelbrecht J, Arts T. Optimizing ventricular fibers: uniform strain or stress, but not ATP consumption, leads to high efficiency.Am J Physiol Heart Circ Physiol. 2002; 283:H1072–H1081. doi: 10.1152/ajpheart.00874.2001CrossrefMedlineGoogle Scholar6. Bell SP, Nyland L, Tischler MD, McNabb M, Granzier H, LeWinter MM. Alterations in the determinants of diastolic suction during pacing tachycardia.Circ Res. 2000; 87:235–240.LinkGoogle Scholar7. Dong SJ, Hees PS, Huang WM, Buffer SA, Weiss JL, Shapiro EP. Independent effects of preload, afterload, and contractility on left ventricular torsion.Am J Physiol. 1999; 277:H1053–H1060. doi: 10.1152/ajpheart.1999.277.3.H1053MedlineGoogle Scholar8. Hansen DE, Daughters GT, Alderman EL, Ingels NB, Stinson EB, Miller DC. Effect of volume loading, pressure loading, and inotropic stimulation on left ventricular torsion in humans.Circulation. 1991; 83:1315–1326.LinkGoogle Scholar9. MacGowan GA, Burkhoff D, Rogers WJ, Salvador D, Azhari H, Hees PS, Zweier JL, Halperin HR, Siu CO, Lima JA, Weiss JL, Shapiro EP. Effects of afterload on regional left ventricular torsion.Cardiovasc Res. 1996; 31:917–925.CrossrefGoogle Scholar10. Notomi Y, Setser RM, Shiota T, Martin-Miklovic MG, Weaver JA, Popović ZB, Yamada H, Greenberg NL, White RD, Thomas JD. Assessment of left ventricular torsional deformation by Doppler tissue imaging: validation study with tagged magnetic resonance imaging.Circulation. 2005; 111:1141–1147. doi: 10.1161/01.CIR.0000157151.10971.98LinkGoogle Scholar11. Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ, Rosen BD, Lima JA, Torp H, Ihlen H, Smiseth OA. New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography.Circulation. 2005; 112:3149–3156. doi: 10.1161/CIRCULATIONAHA.104.531558LinkGoogle Scholar12. Notomi Y, Lysyansky P, Setser RM, Shiota T, Popović ZB, Martin-Miklovic MG, Weaver JA, Oryszak SJ, Greenberg NL, White RD, Thomas JD. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging.J Am Coll Cardiol. 2005; 45:2034–2041. doi: 10.1016/j.jacc.2005.02.082CrossrefMedlineGoogle Scholar13. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography.J Am Soc Echocardiogr. 2011; 24:277–313. doi: 10.1016/j.echo.2011.01.015CrossrefMedlineGoogle Scholar14. Stöhr EJ, Shave RE, Baggish AL, Weiner RB. Left ventricular twist mechanics in the context of normal physiology and cardiovascular disease: a review of studies using speckle tracking echocardiography.Am J Physiol Heart Circ Physiol. 2016; 311:H633–H644. doi: 10.1152/ajpheart.00104.2016CrossrefGoogle Scholar15. Sabatino J, Di Salvo G, Fraisse A, Prota C, Bucciarelli V, Josen M, Paredes J, Sirico D, Voges I, Krupickova S, Indolfi C, Prasad S, Daubeney P. Left ventricular twist mechanics to identify left ventricular noncompaction in childhood.Circ Cardiovasc Imaging. 2019; 12:e007805. doi: 10.1161/CIRCIMAGING.118.007805LinkGoogle Scholar16. Shi WY, Moreno-Betancur M, Nugent AW, Cheung M, Colan S, Turner C, Sholler GF, Robertson T, Justo R, Bullock A, King I, Davis AM, Daubeney PEF, Weintraub RG; National Australian Childhood Cardiomyopathy Study. Long-term outcomes of childhood left ventricular noncompaction cardiomyopathy.Circulation. 2018; 138:367–376. doi: 10.1161/CIRCULATIONAHA.117.032262LinkGoogle Scholar17. Amzulescu MS, Rousseau MF, Ahn SA, Boileau L, de Meester de Ravenstein C, Vancraeynest D, Pasquet A, Vanoverschelde JL, Pouleur AC, Gerber BL. Prognostic impact of hypertrabeculation and noncompaction phenotype in dilated cardiomyopathy: a CMR study.JACC Cardiovasc Imaging. 2015; 8:934–946. doi: 10.1016/j.jcmg.2015.04.015CrossrefMedlineGoogle Scholar18. Bellavia D, Michelena HI, Martinez M, Pellikka PA, Bruce CJ, Connolly HM, Villarraga HR, Veress G, Oh JK, Miller FA. Speckle myocardial imaging modalities for early detection of myocardial impairment in isolated left ventricular non-compaction.Heart. 2010; 96:440–447. doi: 10.1136/hrt.2009.182170CrossrefGoogle Scholar19. van Dalen BM, Caliskan K, Soliman OI, Kauer F, van der Zwaan HB, Vletter WB, van Vark LC, Ten Cate FJ, Geleijnse ML. Diagnostic value of rigid body rotation in noncompaction cardiomyopathy.J Am Soc Echocardiogr. 2011; 24:548–555. doi: 10.1016/j.echo.2011.01.002CrossrefMedlineGoogle Scholar20. Pacileo G, Baldini L, Limongelli G, Di Salvo G, Iacomino M, Capogrosso C, Rea A, D’Andrea A, Russo MG, Calabrò R. Prolonged left ventricular twist in cardiomyopathies: a potential link between systolic and diastolic dysfunction.Eur J Echocardiogr. 2011; 12:841–849. doi: 10.1093/ejechocard/jer148CrossrefGoogle Scholar21. van Dalen BM, Vletter WB, Soliman OI, ten Cate FJ, Geleijnse ML. Importance of transducer position in the assessment of apical rotation by speckle tracking echocardiography.J Am Soc Echocardiogr. 2008; 21:895–898. doi: 10.1016/j.echo.2008.02.001CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Mohammadi E, Nasiraei‐Moghaddam A and Uecker M (2022) Real‐time radial tagging for quantification of left ventricular torsion, Magnetic Resonance in Medicine, 10.1002/mrm.29169, 87:6, (2741-2756), Online publication date: 1-Jun-2022. Dandel M and Hetzer R (2021) Ventricular systolic dysfunction with and without altered myocardial contractility: Clinical value of echocardiography for diagnosis and therapeutic decision-making, International Journal of Cardiology, 10.1016/j.ijcard.2020.11.068, 327, (236-250), Online publication date: 1-Mar-2021. Gunta P, López-Candales A, Baweja P and Sweeney M Tilting of the Cardiac Axis During Dobutamine Stress Echocardiography: Potential Marker for Ischemia, Cureus, 10.7759/cureus.15605 Guigui S, Horvath S, Arenas I and Mihos C (2022) Cardiac geometry, function and mechanics in left ventricular non-compaction cardiomyopathy with preserved ejection fraction, Journal of Echocardiography, 10.1007/s12574-021-00560-7 Related articlesLeft Ventricular Twist Mechanics to Identify Left Ventricular Noncompaction in ChildhoodJolanda Sabatino, et al. Circulation: Cardiovascular Imaging. 2019;12 April 2019Vol 12, Issue 4 Advertisement Article InformationMetrics © 2019 American Heart Association, Inc.https://doi.org/10.1161/CIRCIMAGING.119.009085PMID: 31002264 Originally publishedApril 12, 2019 KeywordscontractionEditorialsrotationtorsion, mechanicalarchitecturefibersPDF download Advertisement SubjectsEchocardiography" @default.
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