Peak systolic LV twist and twist-to-shortening ratio were highest in aortic stenosis patients with both angina and strain (n=8) compared to those with either (n=28) or neither (n=22).
Observational (n=90)
Are peak systolic LV twist and twist-to-shortening ratio increased in aortic stenosis patients with signs of subendocardial ischemia?
Speckle tracking echocardiography demonstrates that increased LV twist and twist-to-shortening ratio are associated with severity and ischemic signs in aortic stenosis, suggesting their utility as markers of subendocardial dysfunction.
BACKGROUND: Angina and an electrocardiographic strain pattern are potential manifestations of subendocardial ischemia in aortic stenosis (AS). Left ventricular (LV) twist is known to increase proportionally to the severity of AS, which may be a result of loss of the inhibiting effect of the subendocardial fibers due to subendocardial dysfunction. It has also been shown that the ratio of LV twist to circumferential shortening of the endocardium (twist-to-shortening ratio TSR) is a reliable parameter of subendocardial dysfunction. The aim of this study was to investigate whether these markers are increased in AS patients with angina and/or electrocardiographic strain. METHODS: The study comprised 60 AS patients with an aortic valve area 50%, and 30 healthy-for age and gender matched-control subjects. LV rotation parameters were determined by speckle tracking echocardiography. RESULTS: Comparison of patients without angina and strain (n = 22), with either angina or strain (n = 28), and with both angina and strain (n = 8), showed highest peak systolic LV apical rotation, peak systolic LV twist, and TSR, in patients with more signs of subendocardial ischemia. In a multivariate linear regression model, only severity of AS and the presence of angina and/or strain could be identified as independent predictors of peak systolic LV twist and TSR. CONCLUSIONS: Peak systolic LV twist and TSR are increased in AS patients and related to the severity of AS and symptoms (angina) or electrocardiographic signs (strain) compatible with subendocardial ischemia.
Dalen et al. (Thu,) conducted a observational in Aortic Stenosis (n=90). Angina and/or electrocardiographic strain vs. AS patients without angina and strain, and healthy controls was evaluated on Peak systolic LV apical rotation, peak systolic LV twist, and twist-to-shortening ratio (TSR). Peak systolic LV twist and twist-to-shortening ratio were highest in aortic stenosis patients with both angina and strain (n=8) compared to those with either (n=28) or neither (n=22).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: