Abstract 4729: The Effect of Loading Alterations on Left Ventricular Torsion: A Simultaneous Catheterization and Two-dimensional Speckle Tracking Echocardiographic Study
Background A preliminary study showed that LV torsion increases in patients with mild diastolic dysfunction and normal EF before decreases with worsening of diastolic function. We hypothesized load alteration is one of major determinants of LVtor and untwisting in human. The aims of this study were (1) to evaluate the effect of load reduction in LVtor and untwisting and (2) to correlate the change in LVtor with invasive high-fidelity LV hemodynamic parameters.
Methods and Results Simultaneous echocardiography and LV pressure measurements were performed in 15 patients (age 65±12). All had normal EF(58.4±16%). Loading condition was changed by nitroprusside infusion, which resulted in decreased LV systolic pr. and a decrease in LV filling pr. Peak LVtor, peak AR, TR, UTR were significantly increased after nitroprusside infusion compared with baseline (See table⇓). Significant correlation were found between ΔLVEDP and ΔLVtor (r = −0.56, P=0.02), ΔTR (r = −0.55, P=0.03) and ΔUTR (r = 0.55, P=0.03). Δ minimum LV pr.was highly correlated with ΔLVtor (r = −0.68, P=0.006), ΔTR (r = −0.72, P=0.003) and ΔUTR (r = 0.54, P=0.04).
Conclusions LV torsion, TR and UTR are significantly increased after afterload reduction, the degree of which correlates with the fall in minimum early diastolic LV pr. and LVEDP. These findings demonstrate the relationship of LVtor and untwisting to ventricular suction and filling.