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Role of Left Ventricular Twist Mechanics in the Assessment of Cardiac Dyssynchrony in Heart Failure

Matteo Bertini, MD^_*,, Partho P. Sengupta, MBBS, MD, DM, Gaetano Nucifora, MD^_*, Victoria Delgado, MD^_*, Arnold C.T. Ng, MBBS^_*, Nina Ajmone Marsan, MD^_*, Miriam Shanks, MD^_*, Rutger R.J. van Bommel, MD^_*, Martin J. Schalij, MD, PhD^_*, Jagat Narula, MD, PhD, Jeroen J. Bax, MD, PhD^_*,_*

^_* Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
Department of Cardiology, University of Bologna, Bologna, Italy
Department of Cardiology, Mayo Clinic, Scottsdale, Arizona
Department of Cardiology, University of California, Irvine, California

^_* Reprint requests and correspondence: Dr. Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands (Email: j.j.bax{at}lumc.nl).

The authors discuss an incremental value of assessing left ventricular (LV) twist mechanics in patients with heart failure (HF) and its potential usefulness in characterizing response to cardiac resynchronization therapy (CRT) and reversal of LV remodeling at 6 months follow-up. They also underscore a critical relationship between LV lead position and changes in LV twist after CRT, and suggest that the reversal of LV remodeling in HF patients following CRT primarily results from restoration of the global sequence of LV twist mechanics.

Key Words: left ventricular twist • heart failure • cardiac resynchronization therapy

Abbreviations and Acronyms   CRT = cardiac resynchronization therapy   HF = heart failure   LV = left ventricle/ventricular   LVEF = left ventricular ejection fraction   MI = myocardial infarction   RV = right ventricle/ventricular