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Decreased left ventricular torsion in patients with isolated mitral stenosis

Verminderte linksventrikuläre Torsion bei Patienten mit isolierter Mitralstenose

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Abstract

Background

Left ventricular (LV) torsion is a sensitive indicator of myocardial contractility and cardiac structure, and has recently been recognized as a sensitive indicator of cardiac performance. The aim of our study was to assess the effect of isolated mitral stenosis on LV torsion.

Patients and methods

We enrolled 19 patients with isolated mitral stenosis and 19 age- and gender-matched healthy subjects in the study. All patients had a normal sinus rhythm. All study subjects underwent two-dimensional echocardiography. Basal and apical LV rotations and LV torsion were evaluated using speckle-tracking echocardiography.

Results

Demographic characteristics, basic echocardiographic measures of LV ejection fraction, LV wall thickness, and LV mass index were similar between the two groups. The degrees of LV torsion (11.3 ± 4.7, 15.4 ± 4.9°, p=0.014) and LV basal rotation (− 3.7 ± 1.9, − 6.5 ± 2.1°, p< 0.001) were significantly decreased in the mitral stenosis group. There was a moderate positive correlation between mitral valve area and LV torsion (r=0.531, p=0.019).

Conclusion

We showed significant reductions in LV torsion and LV basal rotation in patients with mitral valve stenosis. Structural and anatomical changes occurring during the progression of mitral stenosis may be responsible for these impaired movements.

Zusammenfassung

Hintergrund

Die linksventrikuläre (LV-)Torsion ist ein empfindlicher Indikator der Myokardkontraktilität und der Herzstruktur und ist vor Kurzem auch als empfindlicher Indikator der Herzleistung identifiziert worden. Ziel der vorliegenden Studie war es, die Auswirkungen einer isolierten Mitralstenose auf die LV-Torsion zu untersuchen.

Methoden

In die Studie aufgenommen wurden 19 Patienten mit isolierter Mitralstenose und 19 diesen in Alter und Geschlecht entsprechende gesunde Personen. Sämtliche Patienten wiesen einen normalen Sinusrhythmus auf. Bei allen Studienteilnehmern wurde eine 2-dimensionale Echokardiographie durchgeführt. Mit der Speckle-Tracking-Echokardiographie wurden die basale und apikale LV-Rotation sowie die LV-Torsion bestimmt.

Ergebnisse

In beiden Gruppen waren die demographischen Kennzeichen sowie grundlegende Echokardiographieparameter wie LV-Ejektionsfraktion, LV-Wanddicke und LV-Massenindex ähnlich. Der Grad der LV-Torsion (11,3 ± 4,7; 15,4 ± 4,9°; p=0,014) und der basalen LV-Rotation (− 3,7 ± 1,9; − 6,5 ± 2,1°; p< 0,001) waren in der Gruppe mit Mitralstenose signifikant vermindert. Es bestand eine mäßige positive Korrelation zwischen dem Mitralklappenbereich und der LV-Torsion (r=0,531; p=0,019).

Schlussfolgerung

In dieser Studie wurde eine signifikante Verminderung der LV-Torsion und der basalen LV-Rotation bei Patienten mit Mitralklappenstenose nachgewiesen. Möglicherweise sind strukturelle und anatomische Veränderungen, die im Verlauf der Progression der Mitralstenose auftreten, für diese eingeschränkte Beweglichkeit ursächlich.

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Compliance with ethical guidelines

Conflict of interest. B. Kirilmaz, F. Asgun, and S. Saygi state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Department of Cardiology, Canakkale Onsekiz Mart University, 17100, Kepez, Canakkale, Turkey

    B. Kirilmaz MD & S. Saygi

  2. Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Canakkale, Turkey

    F. Asgun

  3. Department of Cardiology, Izmir University, Izmir, Turkey

    E. Ercan

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  1. B. Kirilmaz MD
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  2. F. Asgun
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Correspondence to B. Kirilmaz MD.

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Kirilmaz, B., Asgun, F., Saygi, S. et al. Decreased left ventricular torsion in patients with isolated mitral stenosis. Herz 40, 123–128 (2015). https://doi.org/10.1007/s00059-013-3970-4

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  • DOI: https://doi.org/10.1007/s00059-013-3970-4

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