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Evaluation of left ventricular torsion in children with hypertrophic cardiomyopathy

Christian Prinz1, Lothar Faber1, Dieter Horstkotte1

  • 11 Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.

Cardiology in the Young
|February 8, 2013
PubMed

Insights

In children, hypertrophic cardiomyopathy shows increased torsion due to enhanced basal rotation, unlike concentric hypertrophy

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Echocardiography

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition affecting children.
  • Understanding the mechanics of left ventricular (LV) torsion is crucial for diagnosing and managing pediatric cardiac diseases.
  • Speckle-tracking echocardiography offers advanced insights into myocardial mechanics.

Purpose of the Study:

  • To investigate and compare the role of myocardial torsion in children diagnosed with hypertrophic cardiomyopathy (HCM) versus concentric hypertrophy.
  • To differentiate the torsion patterns between these two pediatric cardiac conditions using advanced echocardiographic techniques.

Main Methods:

  • Speckle-tracking echocardiography was employed in 88 children.
  • The study included children with idiopathic hypertrophic cardiomyopathy (n=24) and concentric hypertrophy (n=20).
  • Patients were compared with 44 age- and gender-matched healthy controls.

Main Results:

  • Children with hypertrophic cardiomyopathy exhibited increased torsion, driven by enhanced basal clockwise rotation and delayed diastolic untwisting.
  • In contrast, concentric hypertrophy showed elevated torsion due to increased apical rotation, with higher peak untwisting velocities.
  • A negative correlation between LV muscle mass and torsion was observed in HCM patients.

Conclusions:

  • Hypertrophic cardiomyopathy in children is characterized by increased basal clockwise rotation, differentiating it from the counterclockwise apical rotation seen in concentric hypertrophy.
  • Both conditions demonstrate delayed diastolic untwisting.
  • Myocardial torsion may serve as a valuable imaging biomarker for guiding the management of pediatric hypertrophic cardiomyopathy.
Abstract

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