Nemes Attila, Kormányos Árpád, Ruzsa Zoltán, Achim Alexandru, Ambrus Nóra, Lengyel Csaba
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Quant Imaging Med Surg. 2023 Oct 1;13(10):6583-6589. doi: 10.21037/qims-23-178. Epub 2023 Sep 1.
Left ventricular (LV) rotational mechanics play a crucial role in LV pump function by strengthening and improving its efficacy. Dependence of LV rotational parameters on left atrial volumes has already been demonstrated. The evaluation of the effect of LV rotational mechanics on LV volumes was purposed in a population of healthy subjects by three-dimensional speckle-tracking echocardiography (STE).
The study comprised 175 healthy subjects with a mean age of 32.8±12.2 years (79 males). All subjects underwent a complete physical examination, laboratory assessments, standard 12-lead electrocardiography and two-dimensional Doppler and three-dimensional STE, the results of these examinations were within the normal range.
Increased basal LV rotation was associated with increased LV volume measured in end-systole and impaired LV ejection fraction. Increased apical LV rotation was associated with reduced LV volumes assessed in end-diastole and in end-systole and increased ejection fraction of the LV. Elevated basal LV rotation showed associations with increased LV mass. In case of increasing basal LV rotation, apical LV rotation showed a decreasing tendency and LV twist showed a tendency of increasing. Similarly, lower basal LV rotation and increased LV twist were seen with increasing apical LV rotation. Increasing LV end-diastolic volume was associated with increasing LV volume measured in end-systole and preserved ejection fraction of the LV. Increasing LV end-systolic volume was associated with increasing LV end-diastolic volume and reduction of LV ejection fraction. Increasing LV volumes were associated with increasing LV mass. While increased LV volumes were associated with reduced apical LV rotation and twist, basal LV rotation did not show significant changes.
LV rotational mechanics are strongly associated with LV volumes in healthy adults suggesting its volume-dependence.
左心室(LV)旋转力学通过增强和改善其效能在左心室泵功能中起关键作用。左心室旋转参数对左心房容积的依赖性已得到证实。本研究旨在通过三维斑点追踪超声心动图(STE)评估健康受试者群体中左心室旋转力学对左心室容积的影响。
该研究纳入了175名健康受试者,平均年龄为32.8±12.2岁(79名男性)。所有受试者均接受了全面的体格检查、实验室评估、标准12导联心电图以及二维多普勒和三维STE检查,这些检查结果均在正常范围内。
基础左心室旋转增加与收缩末期测量的左心室容积增加以及左心室射血分数受损相关。心尖部左心室旋转增加与舒张末期和收缩末期评估的左心室容积减小以及左心室射血分数增加相关。基础左心室旋转升高与左心室质量增加相关。在基础左心室旋转增加的情况下,心尖部左心室旋转呈下降趋势,左心室扭转呈增加趋势。同样,随着心尖部左心室旋转增加,基础左心室旋转降低且左心室扭转增加。左心室舒张末期容积增加与收缩末期测量的左心室容积增加以及左心室射血分数保留相关。左心室收缩末期容积增加与左心室舒张末期容积增加以及左心室射血分数降低相关。左心室容积增加与左心室质量增加相关。虽然左心室容积增加与心尖部左心室旋转和扭转减少相关,但基础左心室旋转未显示出显著变化。
在健康成年人中,左心室旋转力学与左心室容积密切相关,提示其对容积的依赖性。