Kauer Floris, Geleijnse Marcel Leonard, van Dalen Bastiaan Martijn
Floris Kauer, Marcel Leonard Geleijnse, Bastiaan Martijn van Dalen, Erasmus University Medical Center Rotterdam, The Thoraxcenter, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
World J Cardiol. 2015 Aug 26;7(8):476-82. doi: 10.4330/wjc.v7.i8.476.
Left ventricular twist is an essential part of left ventricular function. Nevertheless, knowledge is limited in "the cardiology community" as it comes to twist mechanics. Fortunately the development of speckle tracking echocardiography, allowing accurate, reproducible and rapid bedside assessment of left ventricular twist, has boosted the interest in this important mechanical aspect of left ventricular deformation. Although the fundamental physiological role of left ventricular twist is undisputable, the clinical relevance of assessment of left ventricular twist in cardiomyopathies still needs to be established. The fact remains; analysis of left ventricular twist mechanics has already provided substantial pathophysiological understanding on a comprehensive variety of cardiomyopathies. It has become clear that increased left ventricular twist in for example hypertrophic cardiomyopathy may be an early sign of subendocardial (microvascular) dysfunction. Furthermore, decreased left ventricular twist may be caused by left ventricular dilatation or an extensive myocardial scar. Finally, the detection of left ventricular rigid body rotation in noncompaction cardiomyopathy may provide an indispensible method to objectively confirm this difficult diagnosis. All this endorses the value of left ventricular twist in the field of cardiomyopathies and may further encourage the implementation of left ventricular twist parameters in the "diagnostic toolbox" for cardiomyopathies.
左心室扭转是左心室功能的重要组成部分。然而，在“心脏病学界”，关于扭转力学的知识有限。幸运的是，斑点追踪超声心动图的发展使得能够在床旁对左心室扭转进行准确、可重复且快速的评估，这激发了人们对左心室变形这一重要力学方面的兴趣。尽管左心室扭转的基本生理作用无可争议，但在心肌病中评估左心室扭转的临床相关性仍有待确定。事实是，对左心室扭转力学的分析已经为多种心肌病提供了大量的病理生理学理解。已经明确，例如肥厚型心肌病中左心室扭转增加可能是心内膜下（微血管）功能障碍的早期迹象。此外，左心室扭转减少可能由左心室扩张或广泛的心肌瘢痕引起。最后，在心肌致密化不全心肌病中检测到左心室刚体旋转可能为客观确诊这一疑难病症提供不可或缺的方法。所有这些都证实了左心室扭转在心肌病领域的价值，并可能进一步促使将左心室扭转参数纳入心肌病的“诊断工具箱”。
