Author + information
- Received June 9, 2010
- Revision received November 4, 2010
- Accepted November 22, 2010
- Published online April 1, 2011.
- Myung-Ki Seo, MD,
- Sung-A. Chang, MD, PhD,
- Hyung-Kwan Kim, MD, PhD⁎ ( )(, )
- Dong-Ho Shin, MD,
- Eue-Keun Choi, MD, PhD,
- Yong-Jin Kim, MD, PhD,
- Seil Oh, MD, PhD,
- Goo-Yeong Cho, MD, PhD,
- Dae-Won Sohn, MD, PhD,
- Byung-Hee Oh, MD, PhD and
- Young-Bae Park, MD, PhD
- ↵⁎Reprint requests and correspondence:
Dr. Hyung-Kwan Kim, Department of Internal Medicine, Cardiovascular Center Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea
Objectives This study set out to investigate the isolated impact of synchronous patterns of left ventricular (LV) contraction (i.e., LV synchronicity) on LV twist behavior.
Background Although the relationships between LV loading status/LV contractility and twist are well-established, no data are available regarding the relation between LV twist and LV synchronicity, without any interference by changes in LV pre-load, afterload, and contractility. Serial assessment of patients with Wolff-Parkinson-White syndrome before and after radiofrequency catheter ablation (RFCA) allows this to be explored.
Method Of the 40 Wolff-Parkinson-White patients initially screened, 34 were enrolled. Two-dimensional and Doppler echocardiography along with speckle tracking-derived LV twist mechanics, apical-basal rotation delay, and left ventricular dyssynchrony index (LVdys) were obtained before and after RFCA. The LVdys was defined as the maximal delay in time-to-peak radial strain of different LV segments at the papillary muscle level.
Results Overall, no significant changes were demonstrated in LV volumes, systolic and diastolic function, and end-systolic wall stress before versus after RFCA. After RFCA, median value of LVdys was attenuated from 33.5 (interquartile range [IQR]: 14.0 to 84.3) to 14.0 (IQR: 11.5 to 21.8) (p = 0.002), which was accompanied by a reduction in apical-basal rotation delay from 9.7% (IQR: 3.5 to 23.7) to 3.3% (IQR: 1.3 to 8.0) (p = 0.004). In contrast, LV twist increased from 14.2° (IQR: 9.1° to 18.4°) before to 19.7° (IQR: 15.0° to 22.6°) after RFCA (p = 0.002). Delta LV twist pre- to post-RFCA displayed a significant inverse correlation with changes in apical-basal rotation delay (r = −0.42, p = 0.01) and Delta LVdys (r = −0.39, p = 0.02).
Conclusions The LV synchronous contraction is significantly related to LV twist.
This study was partly supported by grants from the Korea Health 21 R&D Project, Ministry of Health and Welfare, South Korea (A090064).
- Received June 9, 2010.
- Revision received November 4, 2010.
- Accepted November 22, 2010.
- American College of Cardiology Foundation