Right Ventricular Segmental Rotation and Torsion in Normal Subjects on 2D Speckle Tracking Echocardiography

Background/Aims: Little is known about the complex anatomy of right ventricular (RV) torsion in the general population. This study was designed to assess RV’s global and segmental torsional motion in subjects without cardiac pathologies.Methods: We used the Vivid 7 ultrasound system (GE Healthcare, Chicago, IL, USA) to acquire parasternal short-axis views of the RV at the basal and apical levels, and analyzed global and segmental torsion using a 2D speckle tracking algorithm in EchoPAC workstation (GE Healthcare, Wauwatosa, WI, USA).Results: Forty-eight individuals (44 ± 17 years, 54% male) were included, with either normal left ventricular diastolic function (group I, n = 40) or grade I diastolic dysfunction (group II, n = 8). Group I showed global peak systolic torsion of 9.0 ± 6.6 degrees with higher segmental torsion in the mid-interventricular septum (IVS) than in the anterior walls (p = 0.001). Global RV torsion showed a very strong positive correlation with apical rotation (r = 0.91, p < 0.001). Group I exhibited higher segmental torsion in the anterior-IVS and mid-IVS walls than group II (9.8 ± 7.1 vs. 3.5 ± 9.6 degrees, p = 0.036; 10.4 ± 9.1 vs. 2.4 ± 12.3 degrees, p = 0.038, respectively).Conclusions: Analysis of RV segmental torsion was feasible using a 2D speckle tracking algorithm. Apical rotation can be used as a simplified index of global RV torsion. Further studies are needed to evaluate the clinical impact of RV torsion in various pathologies.