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Left ventricular rotational mechanics before and after exercise in children
Michael V Di Maria1, Giuseppe Caracciolo2, Steven Prashker3
1The Cardiac Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Pediatric Cardiology, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
In children, exercise enhances left ventricular (LV) pump function primarily through increased apical rotation, not basal rotation. This study highlights unique changes in LV twist displacement loops during exercise.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Limited data exists on how left ventricular (LV) apical and basal rotation contribute to pump function during exercise in children.
- Understanding these mechanics is crucial for assessing cardiac health in pediatric populations.
Purpose of the Study:
- To investigate the hypothesis that increased LV pump function with exercise in children is linked to augmented LV apical and basal rotation.
- To explore the role of rotational mechanics in pediatric cardiac response to physical activity.
Main Methods:
- Prospective study of 42 children (12-18 years) with normal cardiac function, imaged at rest and after moderate exercise.
- Utilized 2D speckle-tracking echocardiography to measure LV rotation, twist, rotational rate, and recoil/untwist rates.
- Calculated LV torsion and constructed twist displacement loops.
Main Results:
- Apical rotation significantly increased post-exercise (7.33° to 11.6°), while basal rotation showed no significant change.
- Peak LV twist, torsion, and twist rate significantly increased with exercise.
- Diastolic untwist rate and systolic loop parameters also showed significant improvements.
Conclusions:
- Enhanced LV apical rotation, but not basal rotation, is associated with improved global LV pump function during exercise in children.
- Exercise induces distinct alterations in LV twist displacement loops in pediatric subjects.
- Findings provide a basis for future research on LV rotational mechanics in pediatric cardiovascular diseases.
