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Longitudinal rotation: an unrecognised motion pattern in patients with dilated cardiomyopathy

Z B Popović1, R A Grimm, A Ahmad

  • 1Division of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

Heart (British Cardiac Society)
|August 1, 2007
PubMed

Insights

Longitudinal rotation (LR) is common in dilated cardiomyopathy (DCM) patients undergoing cardiac resynchronisation therapy (CRT). Clockwise LR predicts reduced end-systolic volume in DCM, with minimal impact from QRS duration.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Heart Failure Management

Background:

  • Heart failure patients often exhibit longitudinal rotation (LR), a heart motion visible in the horizontal long-axis plane.
  • This motion is frequently observed in candidates for cardiac resynchronisation therapy (CRT).

Purpose of the Study:

  • To determine the magnitude and predictors of LR in ischaemic cardiomyopathy (ICM) and idiopathic dilated cardiomyopathy (DCM) patients.
  • To evaluate the predictive value of LR in patients undergoing CRT.

Main Methods:

  • Retrospective analysis of echocardiograms from 45 ICM, 41 DCM patients, and 16 controls.
  • Speckle tracking assessed global and segmental LR and strains.
  • Repeat echocardiography after CRT completion in 64 patients.

Main Results:

  • DCM patients showed significant clockwise LR, irrespective of QRS duration (<130 ms or ≥130 ms).
  • End-diastolic volume, absence of ischaemia, and QRS duration were significant LR predictors.
  • LR correlated with reduced end-systolic volume in DCM, but not in ICM.

Conclusions:

  • Clockwise LR is associated with DCM, with QRS duration having a minor influence.
  • LR is a moderately strong predictor of end-systolic volume reduction during CRT in DCM patients.
Abstract

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