Twist Mechanics of the Left Ventricle: Principles and Application
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TLDR
An algorithm for routine application of LV twist in clinical differentiation of patterns of LV dysfunction encountered in day-to-day practice is presented and variations in LV twist encountered in different experimental and clinical situations are discussed.Abstract:
Left ventricular (LV) twist or torsion represents the mean longitudinal gradient of the net difference in clockwise and counterclockwise rotation of the LV apex and base, as viewed from LV apex. Twist during ejection predominantly deforms the subendocardial fiber matrix, resulting in storage of potential energy. Subsequent recoil of twist deformation is associated with the release of restoring forces, which contributes to LV diastolic relaxation and early diastolic filling. Noninvasive techniques such as magnetic resonance imaging and echocardiography are useful for understanding LV twist dynamics in clinical settings, and data regarding their relative merits and pitfalls are rapidly accumulating. This review is a focused update on the current and evolving applications of LV twist mechanics in clinical cardiology. First, the theoretical framework for understanding the physiological sequence of LV twist during a cardiac cycle is presented. Second, variations in LV twist encountered in different experimental and clinical situations are discussed. Finally, the review presents an algorithm for routine application of LV twist in clinical differentiation of patterns of LV dysfunction encountered in day-to-day practice.read more
Citations
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Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications: Endorsed by the Japanese Society of Echocardiography
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References
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Journal ArticleDOI
Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging
Yuichi Notomi,Peter Lysyansky,Randolph M. Setser,Takahiro Shiota,Zoran B. Popović,Maureen G. Martin-Miklovic,Joan A. Weaver,Stephanie J. Oryszak,Neil L. Greenberg,Richard D. White,James D. Thomas +10 more
TL;DR: The STI estimation of LVtor is concordant with those analyzed by tagged MRI and also showed good agreement with those by DTI (data derived from tissue velocity) and may make the assessment more available in clinical and research cardiology.
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New Noninvasive Method for Assessment of Left Ventricular Rotation Speckle Tracking Echocardiography
Thomas Helle-Valle,Jonas Crosby,Thor Edvardsen,Erik Lyseggen,Brage Amundsen,Hans-Jørgen Smith,Boaz D. Rosen,João A. C. Lima,Hans Torp,Halfdan Ihlen,Otto A. Smiseth +10 more
TL;DR: It is demonstrated that regional LV rotation and torsion can be measured accurately by STE, suggesting a new echocardiographic approach for quantification of LV systolic function.
Journal ArticleDOI
Left ventricular structure and function: basic science for cardiac imaging.
Partho P. Sengupta,Josef Korinek,Marek Belohlavek,Jagat Narula,Mani A. Vannan,Arshad Jahangir,Bijoy K. Khandheria +6 more
TL;DR: The myofiber geometry of the left ventricle (LV) changes gradually from a right-handed helix in the subendocardium to a left-handed one in subepicardium as mentioned in this paper, and the link between LV deformation and the intracavitary flow direction observed during each phase of the cardiac cycle.
Journal ArticleDOI
Three-dimensional left ventricular deformation in hypertrophic cardiomyopathy.
TL;DR: HCM patients had reduced 3D myocardial shortening on a regional basis; however, LV torsion was increased, and the principal strain associated with 3D maximal contraction was slightly depressed in many regions.
Journal ArticleDOI
Enhanced ventricular untwisting during exercise: a mechanistic manifestation of elastic recoil described by Doppler tissue imaging.
Yuichi Notomi,Maureen G. Martin-Miklovic,Stephanie J. Oryszak,Takahiro Shiota,Dimitri Deserranno,Zoran B. Popović,Mario J. Garcia,Neil L. Greenberg,James D. Thomas +8 more
TL;DR: LV torsion and subsequent rapid untwisting appear to be manifestations of elastic recoil, critically linking systolic contraction to diastolic filling, which may assist efficient LV filling, an effect that appears blunted in HCM.