Nemes Attila, Bordács Barbara, Ambrus Nóra, Lengyel Csaba
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary.
J Clin Med. 2025 May 5;14(9):3201. doi: 10.3390/jcm14093201.
: The rotational mechanics of the left ventricle (LV) play a significant role in maintaining systemic circulation. In clinical practice, three-dimensional speckle-tracking echocardiography (3DSTE) is one of the first methods to be used that is suitable for routine, non-invasive investigations, even in healthy individuals, allowing the conduction of extensive but easily feasible tests. In routine clinical practice, mitral annular plane systolic excursion (MAPSE) is used as an easy-to-implement parameter to judge the systolic longitudinal function of the LV; its prognostic significance is also clarified. The relationship between 3DSTE-derived LV rotational mechanics and MAPSE determined by M-mode echocardiography has never been assessed. Therefore, the aim of the present study was to investigate it extensively in healthy adults. : The present study consisted of 108 healthy adult volunteers (mean age 28.1 ± 6.3 years, 50 men). Complete two-dimensional Doppler echocardiography with MAPSE measurements and 3DSTE-derived assessment of LV rotational parameters were performed in all cases. : Both the apical and basal LV rotations and the consequential LV twist showed trends toward increase, with increasing MAPSE resulting in the LV twist being largest when the MAPSE was largest. While reduced basal LV rotation was associated with reduced MAPSE, a further increase in MAPSE with increasing basal LV rotation could not be demonstrated. With an increase in apical LV rotation, a trend toward an increase in MAPSE was seen, and was largest when the apical LV rotation was largest. No correlations could be demonstrated between MAPSE and basal LV rotation and apical LV rotation. : Associations between LV longitudinal shortening, represented by MAPSE, and LV rotational mechanics could be demonstrated in healthy adults. These findings could have implications for assessing LV function in early disease states.
左心室（LV）的旋转力学在维持体循环中起着重要作用。在临床实践中，三维斑点追踪超声心动图（3DSTE）是最早用于常规、非侵入性检查的方法之一，即使在健康个体中也适用，能够进行广泛但易于实施的检测。在常规临床实践中，二尖瓣环平面收缩期位移（MAPSE）被用作判断左心室收缩期纵向功能的一个易于实施的参数；其预后意义也已得到阐明。3DSTE得出的左心室旋转力学与M型超声心动图测定的MAPSE之间的关系从未被评估过。因此，本研究的目的是在健康成年人中广泛探究这一关系。本研究包括108名健康成年志愿者（平均年龄28.1±6.3岁，50名男性）。所有病例均进行了完整的二维多普勒超声心动图检查及MAPSE测量，并通过3DSTE对左心室旋转参数进行评估。左心室心尖部和基部的旋转以及随之产生的左心室扭转均呈增加趋势，随着MAPSE增加，当MAPSE最大时左心室扭转最大。虽然左心室基部旋转减少与MAPSE降低相关，但未证实随着左心室基部旋转增加MAPSE会进一步增加。随着左心室心尖部旋转增加，可见MAPSE有增加趋势，且在心尖部旋转最大时最大。未证实MAPSE与左心室基部旋转和心尖部旋转之间存在相关性。在健康成年人中可证实以MAPSE表示的左心室纵向缩短与左心室旋转力学之间存在关联。这些发现可能对早期疾病状态下左心室功能的评估具有启示意义。
