Relationship between left ventricular twist and myocardial fibrosis in patients with myocardial hypertrophy

doi:10.3877/cma.j.issn.1672-6448.2020.08.009

Abstract

Abstract:

Objective

To analyze the relationship between left ventricular twist and myocardial fibrosis in patients with myocardial hypertrophy by three-dimensional ultrasound speckle tracking imaging.

Methods

From July 2017 to February 2019, 31 patients with myocardial hypertrophy who underwent echocardiography and myocardial magnetic resonance (CMR) examinations at the Fourth Affiliated Hospital of Harbin Medical University were included. According to the late gadolinium enhancement (LGE) on CMR, which can be used to diagnose myocardial fibrosis, the patients were divided into a myocardial hypertrophy with myocardial fibrosis group (n=20), and a myocardial hypertrophy without myocardial fibrosis (n=11). Thirty-five healthy volunteers were also included as a control group. Three-dimensional speckle tracking imaging was used to measure the parameters of left ventricular rotation and torsion, including left ventricular peak rotation on basal plane (LV Prot-base), left ventricular peak rotation on middle plane (LV Prot-mid), left ventricular peak rotation on apical plane (LV Prot-ap), left ventricular torsion (Lvt), and left ventricular peak twist angle (LV Ptw). The conventional two-dimensional ultrasound parameters and the parameters of left ventricular rotation and torsion were compared among the three groups. The relationship between LV Ptw and LGE positive myocardium/left ventricular myocardial weight was analyzed by spearman correlation analysis.

Results

Compared with the control group, the LV Prot-base, LV Prot-mid, LV Prot-ap, and LV Ptw were significantly increased in both the myocardial hypertrophy with and without fibrosis groups (without fibrosis group: t=4.45, 7.51, -5.45, and -6.79, respectively; with fibrosis group: t=-5.53, -9.84, -5.82, and -9.45, respectively; P<0.01). The LV Prot-ap and LV Ptw in the myocardial hypertrophy with fibrosis group were significantly higher than those of the myocardial hypertrophy without fibrosis group (t=-2.71 and 2.36, respectively; P<0.05). The LV Ptw was positively correlated with LGE myocardium/left ventricular myocardial weight (r=0.58, P=0.001).

Conclusion

Three-dimesional speckle tracking technology can effectively evaluate left ventricular rotation and twist in patients with myocardial hypertrophy. The LV Ptw is positively correlated with the extent of myocardial fibrosis and this might provide a new method or choice for detecting myocardial fibrosis in patients with myocardial hypertrophy.

Cai Cai, Li Li, Dong Dong, Li Li, Hao Hao, Dong Dong. Relationship between left ventricular twist and myocardial fibrosis in patients with myocardial hypertrophy[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(08): 759-764.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.08.009

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I08/759

Figures/Tables 4

References 14

1	Muraru D, Niero A, Rodriguez-Zanella H, et al. Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging[J]. Cardiovasc Diagn Ther, 2018, 8(1): 101-117.
2	Kolwicz SC Jr, Tian R. Glucose metabolism and cardiac hypertrophy[J]. Cardiovasc Res, 2011, 90(2): 194-201.
3	Moon JC, Treibel TA, Schelbert EB. Myocardial fibrosis in hypertensive heart failure: Does quality rather than quantity matter?[J]. J Am Coll Cardiol, 2016, 67(3): 261-263.
4	陈石，乔树宾. 肥厚型心肌病心肌纤维化的相关研究进展[J]. 心血管病学进展, 2012, 33(6): 702-705.
5	Coelho-Filho OR, Shah RV, Neilan TG, et al. Cardiac magnetic resonance assessment of interstitial myocardial fibrosis and cardiomyocyte hypertrophy in hypertensive mice treated with spironolactone[J]. J Am Heart Assoc, 2014, 3 (3): e000790.
6	Zhang HJ, Wang H, Sun T, et al. Assessment ofleft ventricular twist mechanics by speckle tracking echocardiography reveals association between LV twist and myocardial fibrosis in patients with hypertrophic cardiomyopathy[J]. Int J Cardiovasc Imaging, 2014, 30(8): 1539-1548.
7	Badano LP, Muraru D. Twist mechanics of the left ventricle[J]. Circ Cardiovasc Imaging, 2019, 12(4): e009085.
8	于微，王小丛，赵丽蓉, 等. 超声三维斑点追踪技术评价原发性高血压患者左心室旋转和扭转[J]. 中国超声医学杂志, 2012, 28(6): 519-522.
9	Seo Y, Ishizu T, Atsumi A, et al. Three-dimensional speckle tracking echocardiography[J]. Circ J, 2014, 78(6): 1290-1301.
10	Imbalzano E, Zito C, Carerj S, et al. Left ventricular function in hypertension:new insight by speckle tracking echocardiography[J]. Echocardiography, 2011, 28(6): 649-657.
11	Urbano Moral JA, Arias Godinez JA, Maron MS, et al. Left ventricular twist mechanics in hypertrophic cardiomyopathy assessed by three-dimensional speckle tracking echocardiography[J]. Am J Cardiol, 2011, 108(12): 1788-1795.
12	Almaas VM, Haugaa KH, Strøm EH, et al. Noninvasive assessment of myocardial fibrosis in patients with obstructive hypertrophic cardiomyopathy[J]. Heart, 2014, 100(8): 631-638.
13	Karaahmet T, Gürel E, Tigen K, et al. The effect of myocardial fibrosis on left ventricular torsion and twist in patients with non-ischemic dilated cardiomyopathy[J]. Cardiol J, 2013, 20(3): 276-286.
14	Kauer F, Geleijnse ML, van Dalen BM. Role of left ventricular twist mechanics in cardiomyopathies, dance of the helices[J]. World J Cardiol, 2015, 7(8): 476-482.

组别	例数	LAD（mm）	IVSd（mm）	LVEDd（mm）	LVPWd（mm）	LVMI（g/m²）	LVEF（%）
健康对照组	35	34.06±3.23	8.63±1.16	44.29±3.25	8.46±1.09	80.30±14.78	63.77±4.12
无心肌纤维化组	11	40.55±2.42^a	16.42±1.27^a	44.55±3.05	12.09±1.12^a	159.98±14.27^a	61.91±2.98
心肌纤维化组	20	40.45±2.84^a	16.01±1.91^a	46.75±3.67	11.36±1.02^a	147.25±27.42^a	62.40±3.72
F值	?	-37.82	224.05	1.61	72.82	114.49	1.39
P值	?	0.000	0.000	0.21	0.000	0.000	0.256

组别	例数	LAD（mm）	IVSd（mm）	LVEDd（mm）	LVPWd（mm）	LVMI（g/m²）	LVEF（%）
健康对照组	35	34.06±3.23	8.63±1.16	44.29±3.25	8.46±1.09	80.30±14.78	63.77±4.12
无心肌纤维化组	11	40.55±2.42^a	16.42±1.27^a	44.55±3.05	12.09±1.12^a	159.98±14.27^a	61.91±2.98
心肌纤维化组	20	40.45±2.84^a	16.01±1.91^a	46.75±3.67	11.36±1.02^a	147.25±27.42^a	62.40±3.72
F值	?	-37.82	224.05	1.61	72.82	114.49	1.39
P值	?	0.000	0.000	0.21	0.000	0.000	0.256

组别	例数	LV Prot-base （°）	LV Prot-mid （°）	LV Prot-ap（°）	LV Ptw（°）	Lvt（°/cm）
健康对照组	35	-5.01±1.53	4.27±1.46	10.78±3.19	8.02±1.75	3.51±0.75
无心肌纤维化组	11	-7.47±1.84^a	7.03±1.50^a	16.54±2.34^a	11.72±2.12^a	3.80±0.89
心肌纤维化组	20	-8.24±1.55^a	7.50±2.06^a	19.34±2.94^ab	14.22±3.12^ab	3.92±1.00
F值	?	29.42	28.05	55.62	47.94	1.56
P值	?	<0.000	<0.000	0.010	<0.005	0.219

组别	例数	LV Prot-base （°）	LV Prot-mid （°）	LV Prot-ap（°）	LV Ptw（°）	Lvt（°/cm）
健康对照组	35	-5.01±1.53	4.27±1.46	10.78±3.19	8.02±1.75	3.51±0.75
无心肌纤维化组	11	-7.47±1.84^a	7.03±1.50^a	16.54±2.34^a	11.72±2.12^a	3.80±0.89
心肌纤维化组	20	-8.24±1.55^a	7.50±2.06^a	19.34±2.94^ab	14.22±3.12^ab	3.92±1.00
F值	?	29.42	28.05	55.62	47.94	1.56
P值	?	<0.000	<0.000	0.010	<0.005	0.219

Please choose a citation manager

Content to export