European Journal of Echocardiography Advance Access originally published online on May 1, 2008
European Journal of Echocardiography 2009 10(1):56-61; doi:10.1093/ejechocard/jen141
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Assessment of regional rotation patterns improves the understanding of the systolic and diastolic left ventricular function: an echocardiographic speckle-tracking study in healthy individuals
1 Department of Clinical Physiology, Heart Centre, Umeå University Hospital, Umeå, Sweden
2 Department of Cardiology, Heart Centre, Umeå University Hospital, Umeå, Sweden
Received 3 October 2007; accepted after revision 21 March 2008; online publish-ahead-of-print 1 May 2008.
* Corresponding author: Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden. Tel: +46 90 7851965; fax: +46 90 137633. E-mail address: ulf.gustafsson{at}medicin.umu.se
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Abstract |
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Aim: To elucidate the complexity of left ventricular motion throughout the cardiac cycle, we studied regional rotation in detail.
Methods and Results: Regional rotation in six subdivisions of the circumference at three levels was studied by using speckle-tracking echocardiography in 40 healthy subjects. At the basal level the inferoseptal segments rotated significantly more clockwise during systole than the opposing anterolateral segments. At the papillary level the inferoseptal segments differed significantly from the anterolateral segments, where the inferoseptal segments rotated clockwise and the anterolateral segments rotated counter-clockwise. The apical level showed significant difference in regional rotation only at aortic valve opening. In early systole, untwist before the main systolic twist was seen at the basal and apical levels; however, the duration of the basal untwist was much longer than that of the apical. The diastolic phases of rotation at the basal and apical levels matched the different filling phases.
Conclusion: Large regional differences in rotation are present at the basal and papillary levels in healthy subjects. The diastolic untwist matches the phases of both the E-wave and A-wave and seems to be related with intraventricular pressure differences, indicating that untwist plays an important role in the filling of the ventricle.
Keywords: Regional rotation; Left ventricular systolic function; Left ventricular diastolic function; Speckle-tracking echocardiography; Diastolic suction; Healthy humans
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