Key result
In healthy volunteers, the Torsion Index measured by speckle-tracking echocardiography was significantly higher in subjects over 55 years of age compared to those 55 years or younger (16.5 vs 13.1 °/cm, p=0.003).
Why the study?
What are the normal reference values for left ventricular myocardial function assessed by Combined Deformation Parameter and Torsion Index using two-dimensional speckle-tracking echocardiography in healthy adults?
Observational (n=90)
No
What are the normal reference values for left ventricular myocardial function assessed by Combined Deformation Parameter and Torsion Index using two-dimensional speckle-tracking echocardiography in healthy adults?
Absolute Event Rate: 16.5% vs 13.1%
p-value: p=0.003
The Combined Deformation Parameter and Torsion Index derived from speckle-tracking echocardiography provide a comprehensive physiological assessment of left ventricular systolic function by integrating twisting and longitudinal shortening.
Age-adjusted torsion index references may be warranted in healthy adults; leaves open validation in disease states.
BACKGROUND: Left ventricular ejection fraction (LVEF) results from the combined action of longitudinal and circumferential contraction, radial thickening, and basal and apical rotation. The study of these parameters together may lead to an accurate assessment of the cardiac function. METHODS: Ninety healthy volunteers, categorized by gender and age (≤ 55 and > 55 years), were evaluated using two-dimensional speckle tracking echocardiography. Transversal views of the left ventricle (LV) were obtained to calculate circumferential strain and left ventricular twist, while three apical views were obtained to determine longitudinal strain (LS) and mitral annular plane systolic excursion (MAPSE). We established the integral myocardial function of the LV according to: 1. The Combined Deformation Parameter (CDP), which includes Deformation Product (DP) - Twist x LS (° x %) - and Deformation Index (DefI) -Twist / LS (° / %)-; and 2. the Torsion Index (TorI): Twist / MAPSE (° / cm). RESULTS: The mean age of our patients was 50.3 ± 11.1 years. CDP did not vary with gender or age. The average DP was - 432 ± 172 ° x %, and the average DefI was - 0.96 ± 0.36 ° / %. DP provides information about myocardial function (normal, pseudonormal, depressed), and the DefI quotient indicates which component (s) is/are affected in cases of abnormality. TorI was higher in volunteers over 55 years (16.5 ± 15.2 vs 13.1 ± 5.0 °/cm, p = 0.003), but did not vary with gender. CONCLUSIONS: The proposed parameters integrate values of twisting and longitudinal shortening. They allow a complete physiological assessment of cardiac systolic function, and could be used for the early detection and characterization of its alteration.
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Llabata et al. (2018) conducted an observational in Healthy (n=90). Age > 55 years vs. Age ≤ 55 years was evaluated on Torsion Index (TorI) (p=0.003). In healthy volunteers, the Torsion Index measured by speckle-tracking echocardiography was significantly higher in subjects over 55 years of age compared to those 55 years or younger (16.5 vs 13.1 °/cm, p=0.003).
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