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

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.