Key result
Cardiac MR reveals reduced peak rotational velocities in septal segments at LV insertion sites.
Observational (n=14)
Velocity encoding cardiac MR reveals that LV insertion into the right ventricle limits rotation of adjacent segments, a normal physiological pattern that must be differentiated from pathological wall motion abnormalities.
Recognizing normal septal velocity reductions from LV insertion sites may avoid misdiagnosing wall motion abnormalities; leaves open validation in disease.
OBJECTIVE: Obtaining new details for rotational motion of left ventricular (LV) segments using velocity encoding cardiac MR and correlating the regional motion patterns to LV insertion sites. METHODS: Cardiac MR examinations were performed on 14 healthy volunteers aged between 19 and 26 years. Peak rotational velocities and circumferential velocity curves were obtained for 16 ventricular segments. RESULTS: Reduced peak clockwise velocities of anteroseptal segments (i.e. Segments 2 and 8) and peak counterclockwise velocities of inferoseptal segments (i.e. Segments 3 and 9) were the most prominent findings. The observations can be attributed to the LV insertion sites into the right ventricle, limiting the clockwise rotation of anteroseptal LV segments and the counterclockwise rotation of inferoseptal segments as viewed from the apex. Relatively lower clockwise velocities of Segment 5 and counterclockwise velocities of Segment 6 were also noted, suggesting a cardiac fixation point between these two segments, which is in close proximity to the lateral LV wall. CONCLUSION: Apart from showing different rotational patterns of LV base, mid ventricle and apex, the study showed significant differences in the rotational velocities of individual LV segments. Correlating regional wall motion with known orientation of myocardial aggregates has also provided new insights into the mechanisms of LV rotational motions during a cardiac cycle. ADVANCES IN KNOWLEDGE: LV insertion into the right ventricle limits the clockwise rotation of anteroseptal LV segments and the counterclockwise rotation of inferoseptal segments adjacent to the ventricular insertion sites. The pattern should be differentiated from wall motion abnormalities in cardiac pathology.
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Codreanu et al. (2013) conducted an observational in Healthy volunteers (n=14). Velocity encoding cardiac MR was evaluated on Peak rotational velocities and circumferential velocity curves for 16 ventricular segments. Cardiac MR in 14 healthy volunteers showed reduced peak clockwise velocities of anteroseptal segments and counterclockwise velocities of inferoseptal segments due to LV insertion sites.
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