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Does Accessory Pathway Significantly Alter Left Ventricular Twist/Torsion? A Study in Wolff‐Parkinson‐White Syndrome by Velocity Vector Imaging
Author(s) -
Aminian Farimah,
Esmaeilzadeh Maryam,
Moladoust Hassan,
Maleki Majid,
Shahrzad Soraya,
Emkanjoo Zahra,
Sadeghpour Anita
Publication year - 2014
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12470
Subject(s) - twist , torsion (gastropod) , velocity vector , anatomy , physics , medicine , cardiology , classical mechanics , geometry , mathematics
Background The aim of this study was to determine the impact of manifest accessory pathway on left ventricle ( LV ) twist physiology in Wolff‐Parkinson‐White ( WPW ) patients. Although this issue was addressed in 1 study based on speckle tracking method, there was no comparative study with a different technique. We planned to use velocity vector imaging ( VVI ) to find out how much an accessory pathway can affect LV twist mechanics. Methods Thirty patients were enrolled regarding inclusion and exclusion criteria. Two serial comprehensive transthoracic echocardiography evaluations were performed before and after radiofrequency catheter ablation ( RFCA ) within 24 hours. Stored cine loops were analyzed using VVI technique and LV twist and related parameters were extracted. Results Comparing pre‐ and post‐ RFCA data, no significant changes were observed in LV systolic and diastolic dimensions, LV ejection fraction ( LVEF ), and Doppler and tissue Doppler‐related parameters. VVI study revealed remarkable rise in peak LV apical rotation (10.3º ± 3.0º to 13.8º ± 3.6º, P < 0.001) and basal rotation (−6.0 ± 1.8º to −7.7 ± 1.8º, P < 0.001) after RFCA . Subsequently LV twist showed a surge from 14.7º ± 3.9º to 20.2º ± 4.4º (P < 0.001). LV untwisting rate changed significantly from −96 ± 67 to −149.0 ± 47.5°/sec (P < 0.001) and apical‐basal rotation delay showed a remarkable decline after RFCA (106 ± 81 vs. 42.8 ± 26.0 msec, P < 0.001). Conclusion Accessory pathways have a major impact on LV twist mechanics.