Cardiac rotation and relaxation in patients with aortic valve stenosis.

Details

Serval ID
serval:BIB_CBB03EE2368D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cardiac rotation and relaxation in patients with aortic valve stenosis.
Journal
European Heart Journal
Author(s)
Nagel E., Stuber M., Burkhard B., Fischer S.E., Scheidegger M.B., Boesiger P., Hess O.M.
ISSN
0195-668X[print], 0195-668X[linking]
Publication state
Published
Issued date
2000
Volume
21
Number
7
Pages
582-589
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Diastolic dysfunction with delayed relaxation and abnormal passive elastic properties has been described in patients with severe pressure overload hypertrophy. The purpose of this study was to evaluate the time course of rotational motion of the left ventricle in patients with aortic valve stenosis using myocardial tagging. METHODS: Myocardial tagging is a non-invasive method based on magnetic resonance which makes it possible to label ('tag') specific myocardial regions. From the motion of the tag's cardiac rotation, radial displacement and translational motion can be determined. In 12 controls and 13 patients with severe aortic valve stenosis systolic and diastolic wall motion was assessed in an apical and basal short axis plane. RESULTS: The normal left ventricle performs a systolic wringing motion around the ventricular long axis with clockwise rotation at the base (-4.4+/-1.6 degrees) and counter-clockwise rotation at the apex (+6.8+/-2.5 degrees) when viewed from the apex. During early diastole an untwisting motion can be observed which precedes diastolic filling. In patients with aortic valve stenosis systolic rotation is reduced at the base (-2.4+/-2.0 degrees; P<0.01) but increased at the apex (+12.0+/-6.0 degrees; P<0.05). Diastolic untwisting is delayed and prolonged with a decrease in normalized rotation velocity (-6.9+/-1.1 s(-1)) when compared to controls (-10.7+/-2.2 s(-1); P<0.001). Maximal systolic torsion is 8.0+/-2.1 degrees in controls and 14.1+/-6.4 degrees (P<0.01) in patients with aortic valve stenosis. CONCLUSIONS: Left ventricular pressure overload hypertrophy is associated with a reduction in basal and an increase in apical rotation resulting in increased torsion of the ventricle. Diastolic untwisting is delayed and prolonged. This may explain the occurrence of diastolic dysfunction in patients with severe pressure overload hypertrophy.
Keywords
Adult, Aged, Aortic Valve Stenosis/diagnosis, Aortic Valve Stenosis/physiopathology, Diastole, Female, Humans, Magnetic Resonance Imaging, Cine/methods, Male, Middle Aged, Myocardial Contraction, Ventricular Function, Left
Pubmed
Web of science
Open Access
Yes
Create date
02/03/2010 17:04
Last modification date
20/08/2019 16:46
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