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Left Ventricular Twisting Modifications in Patients with Left Ventricular Concentric Hypertrophy at Increasing After‐Load Conditions
Author(s) -
Santoro Amato,
Alvino Federico,
Antonelli Giovanni,
Zacà Valerio,
Benincasa Susanna,
Lunghetti Stefano,
Mondillo Sergio
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.12555
Subject(s) - cardiology , medicine , ejection fraction , left ventricular hypertrophy , doppler imaging , muscle hypertrophy , concentric hypertrophy , stenosis , ventricular function , speckle tracking echocardiography , aortic valve stenosis , heart failure , diastole , blood pressure
Aims Left ventricular hypertrophy ( LVH ) develops as a result of several clinical conditions, such as intensive training, hypertension, aortic valve stenosis. Aim of this study was to analyze the left ventricular twist ( LVT ) modifications in LVH patients with increasing after‐load conditions. Methods A total of 131 patients were enrolled: 17 healthy sedentary people (Hg), without concentric LVH ; 45 water polo players ( AT g); 22 patients with hypertensive cardiopathy ( HP g); 47 patients with different degrees of aortic stenosis ( AS g); all patients had concentric LVH , ejection fraction ( EF ) >54%, and were age‐matched. The left ventricular end‐systolic wall stress ( LV ‐ ESWS ) was used as index of after‐load. Results Left ventricular twist value showed a progressive increase from AT g to AS g, according to increasing after‐load. Longitudinal left ventricular function by tissue Doppler imaging ( TDI ) and speckle tracking echocardiography ( STE ) was reduced in HP g and AS g. There was a negative correlation between LVT and longitudinal systolic function at TDI and STE (r = −0.4; P < 0.001; −0.23; P < 0.05). E/A ratio was lower in HP g and AS g than AT g and Hg. LVT was linearly related to LV ‐ ESWS (r = 0.36; P < 0.01), E/A ratio (r = ‐0.59; P < 0.001), E/E′ ratio (r = 0.43; P < 0.001), age (r = 0.5; P < 0.001), relative wall thickness ( RWT ) (r = 0.38; P < 0.01), heart rate ( HR ) (r = 0.3; P < 0.05), maximum (G. max), and mean transvalvular gradient (G. mean) in AS g (r = 0.37; P < 0.01, r = 0.4; P < 0.01). RWT , E/A ratio, and HR were independent predictor of LVT ( β = 0.23; P = 0.007; −0.44; P = 0.001; 0.17; P = 0.049). Only in AS g, G. mean was independent predictor of LVT ( β = 0.44; P = 0.01). Conclusion Left ventricular twist showed a linear trend at increasing after‐load values to compensate the reduction in systolic longitudinal function in pathological LVH patients.