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Left ventricular untwisting during left atrial contraction: a marker for chronic left ventricular diastolic

Yukio Mizuguchi1, Yoshifumi Oishi, Hirokazu Miyoshi

  • 1Cardiovascular Section, Higashi Tokushima National Hospital, National Hospital Organization, 1-1 Ohmukai-kita, Ohtera, Itano, Itano, Tokushima 779-0193, Japan. ymizuguchi@hbhc.go.jp

Journal of Cardiology
|September 7, 2010
PubMed

Insights

Left atrial (LA) enlargement in patients with cardiovascular risk factors is linked to reduced left ventricular (LV) untwisting. This reduced untwisting may indicate chronic LV diastolic dysfunction.

Area of Science:

  • Cardiology
  • Cardiac Mechanics
  • Diastology

Background:

  • Left ventricular (LV) untwisting during left atrial (LA) contraction is a known phenomenon.
  • The association between this motion and chronic LV diastolic dysfunction requires further investigation.

Purpose of the Study:

  • To test the hypothesis that LV untwisting during LA contraction is associated with chronic LV diastolic dysfunction.
  • To identify predictors of the late diastolic untwisting rate (LDUTR).

Main Methods:

  • Echocardiography, including conventional, tissue Doppler, and 2D speckle tracking, was used.
  • Ninety-two patients with cardiovascular risk factors and 36 controls were analyzed.
  • Multivariate regression analysis identified predictors of LDUTR.

Main Results:

  • Patients with cardiovascular risk factors showed significantly higher E/e' and LA volume index compared to controls.
  • LDUTR was significantly lower in patients and controls with E/A ≥1 compared to controls with E/A <1.
  • LDUTR correlated with LV diameter, LA volume index, peak A velocity, E/e', LV wall thickness, and LV radial strain.
  • LA volume index was identified as a strong predictor of LDUTR.

Conclusions:

  • Late diastolic LV untwisting decreases with increasing LA size in patients with cardiovascular risk factors.
  • Reduced LV untwisting may reflect a history of chronic LV diastolic dysfunction.
Abstract

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