Left Ventricular Rotation and Twist: Why Should We Learn?

The left ventricle twists in systole storing potential energy and untwists (recoils) in diastole releasing the energy. Twist aids left ventricular ejection and untwist aids relaxation and ventricular filling. Therefore, rotation and torsion are important in cardiac mechanics. However, the methodology of their investigations is limited to invasive techniques or magnetic resonance imaging. With the advent of speckle tracking echocardiography, however, rotation and torsion (twist) become familiar to echocardiographers. In this review, I outline the mechanism and influencing factors of rotation and torsion with the anticipation of the routine use of these measurements in clinical practice.

[1]  Hiromi Nakai,et al.  Age-related changes in left ventricular twist assessed by two-dimensional speckle-tracking imaging. , 2006, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[2]  F. T. ten Cate,et al.  Influence of cardiac shape on left ventricular twist. , 2010, Journal of applied physiology.

[3]  E. Shapiro,et al.  Independent effects of preload, afterload, and contractility on left ventricular torsion. , 1999, American journal of physiology. Heart and circulatory physiology.

[4]  C. Lorenz,et al.  Left ventricular torsion is equal in mice and humans. , 2000, American journal of physiology. Heart and circulatory physiology.

[5]  R C Gorman,et al.  Dynamic three-dimensional imaging of the mitral valve and left ventricle by rapid sonomicrometry array localization. , 1996, The Journal of thoracic and cardiovascular surgery.

[6]  Gerald D Buckberg,et al.  Basic science review: the helix and the heart. , 2002, The Journal of thoracic and cardiovascular surgery.

[7]  A. Weyman,et al.  Angular Displacement of the Papillary Muscles During the Cardiac Cycle , 1979, Circulation.

[8]  A. Young,et al.  Three‐Dimensional Left Ventricular Deformation in Hypertrophic Cardiomyopathy , 1994, Circulation.

[9]  Neil B. Ingels,et al.  Torsional Deformation of the Left Ventricular Midwall in Human Hearts With Intramyocardial Markers: Regional Heterogeneity and Sensitivity to the Inotropic Effects of Abrupt Rate Changes , 1988, Circulation research.

[10]  Hirotsugu Yamada,et al.  Ventricular untwisting: a temporal link between left ventricular relaxation and suction. , 2008, American journal of physiology. Heart and circulatory physiology.

[11]  Krishnaswamy Chandrasekaran,et al.  Twist mechanics of the left ventricle: principles and application. , 2008, JACC. Cardiovascular imaging.

[12]  Jianwen Wang,et al.  Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure. , 2007, European heart journal.

[13]  Richard D. White,et al.  P Cardiac Imaging easurement of Ventricular Torsion by Two-imensional Ultrasound Speckle Tracking Imaging , 2005 .

[14]  R Beyar,et al.  Noninvasive quantification of left ventricular rotational deformation in normal humans using magnetic resonance imaging myocardial tagging. , 1990, Circulation.

[15]  S. Ommen,et al.  Left ventricular torsion by two-dimensional speckle tracking echocardiography in patients with diastolic dysfunction and normal ejection fraction. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[16]  Richard D. White,et al.  Assessment of Left Ventricular Torsional Deformation by Doppler Tissue Imaging: Validation Study With Tagged Magnetic Resonance Imaging , 2004, Circulation.

[17]  Yong-Jin Kim,et al.  Role of pericardium in the maintenance of left ventricular twist , 2010, Heart.

[18]  V. Roger,et al.  Trends in prevalence and outcome of heart failure with preserved ejection fraction. , 2006, The New England journal of medicine.

[19]  Jianwen Wang,et al.  Left Ventricular Untwisting Rate by Speckle Tracking Echocardiography , 2007, Circulation.

[20]  H. Miyoshi,et al.  Contribution of the pericardium to left ventricular torsion and regional myocardial function in patients with total absence of the left pericardium. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[21]  James D. Thomas,et al.  Maturational and Adaptive Modulation of Left Ventricular Torsional Biomechanics: Doppler Tissue Imaging Observation From Infancy to Adulthood , 2006, Circulation.

[22]  W J Rogers,et al.  Rotational deformation of the canine left ventricle measured by magnetic resonance tagging: effects of catecholamines, ischaemia, and pacing. , 1994, Cardiovascular research.

[23]  E. Shapiro,et al.  MRI assessment of LV relaxation by untwisting rate: a new isovolumic phase measure of tau. , 2001, American journal of physiology. Heart and circulatory physiology.