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Updated: Jul 15, 2026
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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Temporal coupling between papillary muscle strain and left ventricular untwisting during diastole
Nidhal Bouchahda1, Fabian Scheipl2, Haithem Hbid1
1Cardiology A Department, Fattouma Bourguiba University Hospital, Monastir University, Rue du 1er juin 1955, Monastir 5000, Tunisia.
European Heart Journal. Imaging Methods and Practice
|July 14, 2026
Summary
Papillary muscles actively contract during diastole, contributing to left ventricular (LV) untwisting. This active contraction enhances diastolic suction, especially when diastole is shortened.
Area of Science:
- Cardiology
- Cardiac Physiology
- Echocardiography
Background:
- Left ventricular (LV) untwisting is traditionally viewed as a passive recoil process.
- Passive mechanisms may be insufficient for effective diastolic suction during shortened diastole.
Purpose of the Study:
- To investigate the active contribution of anterolateral papillary muscle (APM) and posteromedial papillary muscle (PPM) to LV untwisting.
- To determine if papillary muscles actively assist passive elastic recoil in LV untwisting.
Main Methods:
- Prospective study using two-dimensional speckle-tracking imaging in individuals with normal echocardiograms.
- Measured longitudinal strain of APM and PPM, alongside LV torsion.
- Employed functional data analysis and penalized function-on-function regression to model the association between papillary muscle strain and LV untwisting.
Main Results:
- A significant, time-dependent relationship was found between papillary muscle contraction and LV untwisting.
- Greater APM and PPM contraction correlated with enhanced LV untwisting during early and mid-diastole.
- Peak papillary muscle contractions occurred significantly later in the cardiac cycle than peak LV torsion.
Conclusions:
- Papillary muscles exhibit active contraction during diastole.
- This active contraction is temporally coordinated with and contributes to LV untwisting.
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