Published Online
on February 28, 2005

A more recent version of this article appeared on March 8, 2005

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Submitted on April 27, 2004
Revised on November 23, 2004
Accepted on December 1, 2004

Assessment of Left Ventricular Torsional Deformation by Doppler Tissue Imaging. Validation Study With Tagged Magnetic Resonance Imaging

Yuichi Notomi MD, Randolph M. Setser DSc, Takahiro Shiota MD, Maureen G. Martin-Miklovic , Joan A. Weaver RT, Zoran B. Popovi MD, Hirotsugu Yamada MD, Neil L. Greenberg PhD, Richard D. White MD, and James D. Thomas MD^*

From the Departments of Cardiovascular Medicine (Y.N., T.S., M.G.M.-M., J.A.W., Z.B.P., H.Y., N.L.G., R.D.W., J.D.T.) and Radiology (R.M.S., R.D.W.), Cleveland Clinic Foundation, Cleveland, Ohio.

^* To whom correspondence should be addressed. E-mail: thomasj{at}ccf.org.

Background--Left ventricular (LV) torsional deformation is a sensitive index for LV performance but difficult to measure. The present study tested the accuracy of a novel method that uses Doppler tissue imaging (DTI) for quantifying LV torsion in humans with tagged magnetic resonance imaging (MRI) as a reference.

Methods and Results--Twenty patients underwent DTI and tagged MRI studies. Images of the LV were acquired at apical and basal short-axis levels to assess LV torsion. We calculated LV rotation by integrating the rotational velocity, determined from DTI velocities of the septal and lateral regions, and correcting for the LV radius over time. LV torsion was defined as the difference in LV rotation between the 2 levels. DTI rotational and torsional profiles throughout systole and diastole were compared with those by tagged MRI at isochronal points. Rotation and torsion by DTI were closely correlated with tagged MRI results during systole and early diastole (apical and basal rotation, r=0.87 and 0.90, respectively; for torsion, 0.84; P<0.0001, by repeated-measures regression models). Maximal torsion showed even better correlation (r=0.95, P<0.0001).

Conclusions--The present study has shown that DTI can quantify LV torsional deformation over time. This novel method may facilitate noninvasive quantification of LV torsion in clinical and research settings.

Key words: mechanics • echocardiography • ventricles • magnetic resonance imaging

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