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Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns
Published on: December 22, 2023
Left ventricular untwisting is an important determinant of early diastolic function
Andrew T Burns1, Andre La Gerche, David L Prior
1Cardiac Investigation Unit, St Vincent's Hospital Melbourne, Victoria, Australia. andrew.burns@svhm.org.au.
JACC. Cardiovascular Imaging
|June 13, 2009
Summary
Left ventricular untwisting relates to relaxation and suction, not stiffness. This suggests untwisting is key for early diastolic filling, impacting left ventricular (LV) diastolic function assessment.
Area of Science:
- Cardiology
- Cardiac Mechanics
- Echocardiography
Background:
- Left ventricular (LV) diastolic function involves relaxation and myocardial stiffness.
- LV untwisting, starting before aortic valve closure, may aid diastolic filling.
- Previous studies indirectly linked tau to untwisting; direct invasive measures were lacking.
Purpose of the Study:
- To correlate invasive diastolic function measures with speckle tracking imaging-derived untwisting parameters.
- To investigate the relationship between LV relaxation, suction, stiffness, and untwisting.
Main Methods:
- Simultaneous invasive LV pressure (micromanometer) and echocardiography in 18 patients.
- Measured LV relaxation (dp/dt minimum, tau) and suction (minimum diastolic pressure).
- Assessed LV stiffness and quantified torsion/untwisting using speckle tracking.
Main Results:
- Impaired relaxation (prolonged tau) correlated with delayed untwisting (r = 0.35, p < 0.01).
- Reduced untwisting associated with increased LV minimum diastolic pressure (r = -0.30, p < 0.034).
- No significant correlation found between LV stiffness and untwisting parameters.
Conclusions:
- Untwisting parameters correlate with invasive measures of LV relaxation and suction.
- Untwisting is likely important for early diastolic LV filling, not later events.
- LV stiffness does not appear to be directly related to untwisting.
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