Key result
Counterclockwise LV rigid body rotation links to larger end-systolic aortic valve annular dimensions.
Why the study?
No clear associations had been identified between left ventricular rotational parameters and aortic valve annulus dimensions in healthy adults.
Does left ventricular rigid body rotation affect aortic valve annulus dimensions and systolic excursion in healthy adults compared to normally directed rotational mechanics?
Cross-Sectional (n=110)
No
Does left ventricular rigid body rotation affect aortic valve annulus dimensions and systolic excursion in healthy adults compared to normally directed rotational mechanics?
In healthy adults, left ventricular rigid body rotation is associated with differences in aortic valve annulus dimensions and systolic excursion depending on the direction of rotation (clockwise vs. counterclockwise).
Background: Due to the specific arrangement of left ventricular (LV) muscle fibers, the apex and base of the LV rotate in opposite directions under healthy conditions, resulting in LV twist. However, in certain, primarily pathological, conditions, LV twist is absent, and the base and apex of the LV rotate in the same direction, either counterclockwise (CCW) or clockwise (CW); this motion is known as LV rigid body rotation (RBR). In the literature, no clear associations have currently been identified between LV rotational parameters and aortic valve annulus (AVA) dimensions in healthy adults. Thus, this study aimed to compare AVA dimensions in the presence of LV-RBR with those in cases with normally directed LV rotational mechanics (ND-LVrot) under healthy conditions. Methods: This investigation included 110 healthy subjects, of whom 100 had ND-LVrot (mean age: 35.6 ± 12.0 years; 61 males) and 10 had LV-RBR (mean age: 35.4 ± 11.3 years; 7 males). The presented investigation is part of the "Motion Analysis of the heart and Great vessels bY three-dimensionAl (3D) speckle-tRacking echocardiography (3DSTE) in Healthy subjects" (MAGYAR-Healthy) Study. Results: No differences in AVA dimensions were present between individuals with ND-LVrot and those with LV-RBR at the group level. However, CCW-LV-RBR cases exhibited dilated end-systolic AVA dimensions compared with both ND-LVrot and CW-LV-RBR subjects. AVA plane systolic excursion (AAPSE) was significantly impaired in CW-LV-RBR cases compared with CCW-LV-RBR cases. Basal LV strains did not differ significantly among healthy cases with ND-LVrot, CW-LV-RBR, and CCW-LV-RBR. Conclusions: Although AVA dimensions and AAPSE did not differ between ND-LVrot and LV-RBR cases at the overall group level, significant differences in AVA dimensions and AAPSE were observed between LV-RBR cases with CW and CCW rotational directions.
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Nemes et al. (2026) conducted a cross-sectional in Healthy adults (n=110). Left ventricular rigid body rotation (LV-RBR) vs. Normally directed LV rotational mechanics (ND-LVrot) was evaluated on Aortic valve annular (AVA) dimensions and AVA plane systolic excursion (AAPSE). Although aortic valve annular dimensions did not differ between healthy adults with left ventricular rigid body rotation and normal rotation overall, counterclockwise rotation was associated with significantly dilated end-systolic dimensions.
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