Left ventricular twist in clinically stable heart transplantation recipients: a speckle tracking echocardiography study

Int J Cardiol. 2013 Sep 20;168(1):357-61. doi: 10.1016/j.ijcard.2012.09.042. Epub 2012 Sep 30.

Abstract

Background and aim: Cavity twist is an integral part of LV function and its pattern in transplanted hearts is not well known. This study aimed at exploring LV twist in clinically stable heart transplant (HT) recipients with no evidence for rejection.

Methods: We studied 32 HT patients (54 ± 24 months after HT), 34 other cardiac surgery (CS) patients and compared them with 35 health controls using speckle tracking echocardiography, measuring peak twist angle, time-to-peak twist, and untwist rate.

Results: LV twist angle was smaller in the HT group (6.2 ± 3.3°) in comparison with the CS group and controls (13.2 ± 3.5° and 13.1 ± 4.5°, respectively; p<0.0001 for all) and untwist rate was reduced (HT group: -74 ± 30°/s; CS group: -118 ± 43°/s; controls: -116 ± 39°/s; p<0.0001 for all). Time-to-peak twist was not different between groups. Time after HT was the main independent predictor of both LV twist angle and untwist rate (β=0.8, p<0.0001).

Conclusion: Though clinically stable, LV twist dynamics are significantly impaired in HT recipients, even in comparison with patients who underwent other cardiac surgery.

Keywords: Echocardiography; Heart transplantation; LV function; Speckle tracking; Torsion.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Echocardiography / methods*
  • Exercise Test / methods
  • Female
  • Heart Transplantation / adverse effects*
  • Heart Transplantation / trends
  • Humans
  • Male
  • Middle Aged
  • Torsion Abnormality / diagnostic imaging*
  • Torsion Abnormality / physiopathology
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / physiopathology