Sengupta Partho P, Tajik A Jamil, Chandrasekaran Krishnaswamy, Khandheria Bijoy K
Division of Cardiovascular Diseases, Mayo Clinic Arizona,13400 East Shea Boulevard Scottsdale, AZ 85259, USA.
JACC Cardiovasc Imaging. 2008 May;1(3):366-76. doi: 10.1016/j.jcmg.2008.02.006.
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.
左心室（LV）扭转或扭曲代表从左心室心尖观察到的心尖和心底顺时针和逆时针旋转净差异的平均纵向梯度。射血期间的扭转主要使心内膜下纤维基质变形，导致势能储存。扭转变形的后续回弹与恢复力的释放相关，这有助于左心室舒张期松弛和舒张早期充盈。磁共振成像和超声心动图等非侵入性技术有助于在临床环境中理解左心室扭转动力学，并且关于它们相对优缺点的数据正在迅速积累。本综述重点更新了左心室扭转力学在临床心脏病学中的当前及不断发展的应用。首先，介绍了理解心动周期中左心室扭转生理序列的理论框架。其次，讨论了在不同实验和临床情况下遇到的左心室扭转变化。最后，本综述提出了一种算法，用于在日常实践中遇到的左心室功能障碍模式的临床鉴别中常规应用左心室扭转。
