[Association between left ventricular twist/untwist and diastolic dysfunction of high cardiovascular risk population...

To assess the association between left ventricular (LV) twist and untwist with the severity of diastolic dysfunction of high cardiovascular risk population in the community.

This cross-sectional survey was performed in high cardiovascular risk people with normal left ventricular (LV) ejection fraction in an urban community of Beijing (n = 620). Normal LV diastolic function was defined in 305 subjects, mild diastolic dysfunction in 266 subjects and moderate/severe diastolic dysfunction in 49 subjects. Peak LV twist, peak twist velocity, peak untwist velocity and untwist rate were measured in apical and basal short-axis images using speckle tracking echocardiography.

Peak LV twist was similar among subjects with normal diastolic function, mild diastolic dysfunction and moderate/severe diastolic dysfunction. Peak twist velocity [(129.3 ± 45.3)°/s vs. (118.0 ± 36.2)°/s] and untwist velocity [(-132.9 ± 50.4) °/s vs. (-121.2 ± 41.4)°/s] were significantly higher in mild diastolic dysfunction group than in normal diastolic function group (all P < 0.01) and similar between normal diastolic function and moderate/severe diastolic dysfunction group (P > 0.05). Untwist rate of moderate/severe diastolic dysfunction decreased significantly than that of normal diastolic function [(41.9 ± 32.9)°/s vs. (57.7 ± 36.2) °/s, P < 0.01] and mild diastolic dysfunction group [(41.9 ± 32.9)°/s vs. (60.9 ± 39.9) °/s, P < 0.01].

Twist and untwist parameters are increased/preserved in population with normal systolic function and mild diastolic dysfunction and "normalized" or reduced in those with advanced diastolic dysfunction. The maintaining (if not increasing) of LV twist in early diastolic dysfunction might serve as a compensatory mechanism in case of reduced myocardial relaxation in these subjects.