Cardiothoracic Department and
Cardiothoracic Department and Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy;
Am J Physiol Heart Circ Physiol. 2014 Sep 1;307(5):H680-8. doi: 10.1152/ajpheart.00251.2014. Epub 2014 Jul 3.
Left ventricular (LV) twist (LVT) and untwisting (LVUT) rate are global and thorough parameters of LV function. The aim of the present study was to investigate the differences in LV rotational mechanics between patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM). Twenty consecutive patients with CA, 20 consecutive patients with HCM, and 20 consecutive subjects without evidence of structural heart disease were included. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) imaging was performed to evaluate biventricular function, LV mass index, and presence/extent of LGE. Feature-tracking analysis was applied to LV basal and apical short-axis images to determine peak LVT, time to peak LVT, peak LVUT rate, and time to peak LVUT rate. Peak LVT and peak LVUT rate were significantly impaired in patients with CA compared with controls (P < 0.05 for both). In patients with HCM, peak LVT was increased (P < 0.05) compared with controls, whereas peak LVUT rate was preserved (P > 0.05). Time to peak LVUT rate was significantly prolonged in patients with CA and in patients with HCM compared with controls (ANOVA P < 0.001). At multivariate analysis, age (P = 0.007), LV ejection fraction (P = 0.035) and extent of LGE (P < 0.001) were independently related to peak LVT, and LV mass index (P = 0.015) and extent of LGE (P = 0.004) were independently related to peak LVUT rate, whereas extent of LGE (P < 0.001) was the only variable independently related to time to peak LVUT rate. In conclusion, CA and HCM have specific behavior of LV rotational mechanics. The extent of LGE significantly influences the LV rotational mechanics.
左心室（LV）扭转（LVT）和解旋（LVUT）率是 LV 功能的整体和全面参数。本研究旨在探讨心脏淀粉样变性（CA）和肥厚型心肌病（HCM）患者 LV 旋转力学的差异。连续纳入 20 例 CA 患者、20 例 HCM 患者和 20 例无结构性心脏病证据的患者。进行心脏磁共振（CMR）检查并进行钆延迟增强（LGE）成像，以评估双心室功能、LV 质量指数和 LGE 的存在/程度。应用特征跟踪分析 LV 基底和心尖短轴图像，以确定 LVT 的峰值、LVT 峰值的时间、LVUT 峰值的速度和 LVUT 峰值的时间。与对照组相比，CA 患者的 LVT 峰值明显降低（均 P < 0.05）。与对照组相比，HCM 患者的 LVT 峰值增加（P < 0.05），而 LVUT 峰值的速度保持不变（P > 0.05）。与对照组相比，CA 和 HCM 患者的 LVUT 峰值时间明显延长（方差分析 P < 0.001）。多元分析显示，年龄（P = 0.007）、LV 射血分数（P = 0.035）和 LGE 程度（P < 0.001）与 LVT 峰值独立相关，LV 质量指数（P = 0.015）和 LGE 程度（P = 0.004）与 LVUT 峰值的速度独立相关，而 LGE 程度（P < 0.001）是唯一与 LVUT 峰值时间独立相关的变量。总之，CA 和 HCM 具有特定的 LV 旋转力学行为。LGE 的程度显著影响 LV 的旋转力学。
