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European Journal of Echocardiography Advance Access originally published online on June 6, 2009
European Journal of Echocardiography 2009 10(6):793-800; doi:10.1093/ejechocard/jep072
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Left ventricular torsion and strain patterns in heart failure with normal ejection fraction are similar to age-related changes

Thanh Trung Phan*, Ganesh Nallur Shivu, Khalid Abozguia, Mahadevan Gnanadevan, Ibrar Ahmed and Michael Frenneaux

University of Birmingham, Edgbaston, Birmingham B15 2TT, UK

Received 30 March 2009; accepted after revision 9 May 2009; online publish-ahead-of-print 6 June 2009.

* Corresponding author. Tel: +44 121 414 5916; fax: +44 121414 3713. E-mail address: ttpquang{at}hotmail.com


  Abstract

Aims: We used speckle tracking echocardiography (STE) to make a comparison between the effects of ageing and of heart failure with normal ejection fraction (HfnEF) on left ventricular (LV) torsion and strain patterns.

Methods and results: Forty patients with HfnEF, 27 young controls and 26 older controls, were prospectively recruited. All subjects underwent clinical examination, 12-lead electrocardiogram, pulmonary function test, echocardiogram, and metabolic exercise test. LV torsion increases with advancing age (older controls vs. young controls, 2.2 ± 0.9 vs. 1.4 ± 0.8°/cm; P = 0.03). Circumferential strain was enhanced in patients with HfnEF (–24.7 ± 4.7 vs. –20.0 ± 4.9%; P = 0.003). Rotational deformation delay (time difference between peak basal rotation and peak apical rotation), global circumferential strain, E-velocity deceleration time, and LV end-diastolic volume index were independent predictors of LV torsion. LV torsion and body mass index were independent predictors of LV untwist rate.

Conclusion: Ageing is associated with increased LV torsion secondary to reduced rotational deformation delay and increased peak basal rotation. LV torsion and strain patterns in patients with HfnEF are similar to age-related changes apart from circumferential strain, which is enhanced in patients with HfnEF.

Keywords: Torsion; Untwisting; Heart failure with normal ejection fraction; Ageing; Speckle tracking echocardiography


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