Abstract 14853: Left Ventricular Rotational Mechanics in Children With Dilated Cardiomyopathy
Introduction: Counterclockwise rotation of LV apex and clockwise rotation of its base lead to twisting of LV in systole ("wringing" pump) and untwisting in diastole. In adult dilated cardiomyopathy (DCM), abnormal rotation of apex and base in same direction leads to the LV resembling a “roller” pump rather than a wringing pump. This phenomenon is described as rigid body rotation (RBR). Studies on rotational mechanics in children with DCM are lacking.
Hypothesis: Children with DCM may exhibit decreased rotational mechanics and may display RBR.
Methods: We analyzed 2D speckle tracking images of apex and base in 14 DCM patients (age: 0.7-18 yrs). Rotational indices and torsion-radial displacement (T-D) loops were calculated (Fig. 1A).
Results: In 6 out of 14 (43%) DCM patients, LV apex showed “reversed” rotation resulting in RBR (Fig 2). Other 8 patients showed normal apical rotation, but had decreased rotational indices (Table 1). LVEF was similar in both RBR and non-RBR groups (41.4±14.3% vs 42.5±13.1%, p>0.05). Untwisting was decreased and quite delayed (Fig. 1B).
Conclusions: Children with DCM exhibit impaired rotational mechanics. Almost half lose normal twist pattern resulting in RBR. Area of T-D loop decreases significantly in DCM. Longitudinal studies are needed to determine whether RBR and abnormal T-D loops are signals of impending deterioration of LV function in children with DCM.
Author Disclosures: A. Montero: None. M.J. O’Connor: None. N.G. Pandian: None. A. Banerjee: None.
- © 2016 by American Heart Association, Inc.