A new tissue Doppler method for examination of left ventricular rotation

This paper introduces a new semiautomatic method for assessing regional left ventricular (LV) rotation that uses the velocity field provided by tissue Doppler imaging (TDI). Left ventricular end-systolic angle of twist estimated by the new method has been compared with rotation by magnetic resonance imaging (MRI) tagging, by 2-D speckle tracking echocardiography (STE) and by a TDI method using the velocity difference between the tangential points on the LV circumference in 21 human subjects. The new TDI method gave lower absolute values for end-systolic twist angle than MRI and STE (agreement -4.1 +/- 2.1 degrees and -2.5 +/- 4.0 degrees, respectively). The reproducibility of the new method was as good as for MRI and STE, but worse than the use of TDI velocities in tangential points. The present study has shown that TDI methods constitute useful alternatives to speckle tracking and MRI, and should be considered in future studies of LV twist and rotation.