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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular twist in clinically stable heart transplantation recipients: a speckle tracking echocardiography
Matteo Cameli1, Piercarlo Ballo, Matteo Lisi
1Department of Cardiovascular Diseases, University of Siena, Italy. cameli@cheapnet.it
Insights
Left ventricular (LV) twist is significantly impaired in heart transplant (HT) recipients, even when clinically stable. This reduced LV twist and untwist rate may be linked to the time elapsed since HT.
Area of Science:
- Cardiology
- Cardiac Physiology
- Transplantation Medicine
Background:
- Left ventricular (LV) twist is crucial for cardiac function.
- The pattern of LV twist in heart transplant (HT) recipients is not well understood.
- This study investigates LV twist in stable HT patients without rejection.
Purpose of the Study:
- To explore and quantify left ventricular (LV) twist dynamics in clinically stable heart transplant (HT) recipients.
- To compare LV twist patterns between HT patients, other cardiac surgery (CS) patients, and healthy controls.
Main Methods:
- Speckle tracking echocardiography was used to assess LV twist.
- Key parameters measured included peak twist angle, time-to-peak twist, and untwist rate.
- 32 HT patients, 34 CS patients, and 35 healthy controls were included.
Main Results:
- LV twist angle was significantly smaller in HT recipients (6.2 ± 3.3°) compared to CS patients (13.2 ± 3.5°) and controls (13.1 ± 4.5°).
- Untwist rate was also reduced in HT recipients (-74 ± 30°/s) versus CS patients (-118 ± 43°/s) and controls (-116 ± 39°/s).
- Time after HT was the primary independent predictor for both LV twist angle and untwist rate.
Conclusions:
- Clinically stable heart transplant recipients exhibit significantly impaired LV twist dynamics.
- These impairments are evident even when compared to patients who have undergone other cardiac surgeries.
- LV twist dynamics are notably affected by the time elapsed since heart transplantation.
Background And Aim:
Cavity twist is an integral part of LV function and its pattern in transplanted hearts is not well known. This study aimed at exploring LV twist in clinically stable heart transplant (HT) recipients with no evidence for rejection.
Methods:
We studied 32 HT patients (54 ± 24 months after HT), 34 other cardiac surgery (CS) patients and compared them with 35 health controls using speckle tracking echocardiography, measuring peak twist angle, time-to-peak twist, and untwist rate.
Results:
LV twist angle was smaller in the HT group (6.2 ± 3.3°) in comparison with the CS group and controls (13.2 ± 3.5° and 13.1 ± 4.5°, respectively; p<0.0001 for all) and untwist rate was reduced (HT group: -74 ± 30°/s; CS group: -118 ± 43°/s; controls: -116 ± 39°/s; p<0.0001 for all). Time-to-peak twist was not different between groups. Time after HT was the main independent predictor of both LV twist angle and untwist rate (β=0.8, p<0.0001).
Conclusion:
Though clinically stable, LV twist dynamics are significantly impaired in HT recipients, even in comparison with patients who underwent other cardiac surgery.
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