Left Ventricular Rotation and Torsion in Patients with Perimembranous Ventricular Septal Defect

Background Assessment of left ventricular ( LV ) rotation has become an important approach for quantifying LV function. In this study, we sought to analyze LV rotation and twist using speckle tracking imaging ( STI ) in adult patients with isolated ventricular septal defects. Methods Using STI, the peak rotation and time to peak rotation of 6 segments in basal and apical short‐axis were measured, respectively, in 32 patients with ventricular septal defect and 30 healthy subjects as controls. The global rotation of the 6 segments in basal and apical and LV twist versus time profile were drawn, the peak rotation and twist of LV were calculated. All the time to peak rotation/twist were expressed as a percentage of end‐systole (end‐systole = 100%). Left ventricular ejection fraction was measured by biplane Simpson method. Results In patients group, the peak rotation of posterior, inferior, and postsept wall in basal was higher(P ≤ 0.05) and LV twist was also higher (P ≤ 0.05) than healthy controls. There were no significant differences between 2 groups in the peak rotation of the other 9 segments and left ventricular ejection fraction. Different from the control group, the time to peak rotation of the 6 segments in basal were delayed and the global rotation of the base was delayed (P   ≤   0.05) in ventricular septal defect group. Conclusions Left ventricular volume overload due to ventricular septal defect has significant effect on LV rotation and twist, and LV rotation and twist may be a new index predicting LV systolic function.