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Left ventricular (LV) rotation is the dominant deformation during relaxation and links systole with early diastolic recoil. LV torsion and untwisting rates during submaximal exercise were compared between heart transplant recipients (HTRs), young adults and healthy older individuals to better understand impaired diastolic function in HTRs. Two dimensional and colour M-mode echocardiography with speckle-tracking analysis were completed in eight HTRs (age: 61 +/- 9 years), six recipient age-matched (RM, age: 60 +/- 11 years), and five donor age-matched (DM, age: 35 +/- 8 years) individuals (all males) at rest and during submaximal cycle exercise. LV peak torsion, peak rate of untwisting and peak intraventricular pressure gradients (IVPGs) were examined. LV torsion increased with exercise in DMs (6.5 +/- 5.6 deg, P 0.05). Peak LV torsion and untwisting are blunted during exercise in HTRs and RMs compared to DMs. These factors may contribute to the impaired diastolic filling found in HTRs during exercise. Similarities between HTRs and RMs during exercise suggest functional accelerated ageing of the cardiac allograft.
Esch et al. (Tue,) studied this question.