Abstract 5778: The Impact of Pulmonary Pressure and Right Ventricle on Left Ventricular Torsion Assessed by Speckle Tracking Echocardiography
Background: It is well established that left ventricular (LV) torsion is sensitive to change in both regional and global LV dysfunction. Little is known about the LV torsion in patients (pts) with pulmonary hypertension (PAH).
To evaluate LV torsion in pts with PAH and
to determine the relationship of LV torsion with pulmonary pressure (PASP) and right ventricular (RV) size and function.
Methods: 2-D echo images were prospectively acquired in 44 (age 48±15, 86% F) pts with PAH [RV systolic pressure (RVSP) >36 mmHg] and in 22 age and gender-matched healthy subjects (Control). The majority (>80%) of PAH group consisted of family members of pts with familial PAH who developed RVSP >36 mmHg and those with idiopathic PAH. Pts with significant aortic/mitral diseases, hypertension, and coronary artery disease were excluded. LV torsion and RV function were assessed by speckle tracking.
Results: Estimated PASPs (RVSP) in PAH group were 72±20 mmHg. 70 % of PAH pts had severe PAH (RVSP > 60 mmHg). Peak systolic LV torsion (6±8 vs13±6, p<0.01) was significantly reduced in PAH group compared to control group, Fig1⇓. Peak LV torsion significantly inversely correlated with estimated PASP (r=−0.43, p<0.01), RV free wall longitudinal strain (r= −0.40, p<0.01), and RV area (r= −0.6, p < 0.01).
Peak systolic LV torsion was significantly reduced in pts with PAH.
A reduction in apical rotation is a major contribution of a reduction in peak LV torsion in these pts.
The severity of PAH, RV deformation, and RV enlargement significantly correlated with the magnitude of LV torsion abnormality. This data suggests the twist of the LV was affected by PAH and ventricular interaction.