Left ventricular mechanics in idiopathic dilated cardiomyopathy: systolic-diastolic coupling and torsion

J Am Soc Echocardiogr. 2009 May;22(5):486-93. doi: 10.1016/j.echo.2009.02.022. Epub 2009 Apr 2.

Abstract

Background: In idiopathic dilated cardiomyopathy (IDC), myocardial deformational parameters and their mutual relationships remain incompletely characterized.

Methods: Thirty-seven patients with IDC underwent two-dimensional speckle-tracking echocardiography (2D-STE) to assess left ventricular rotation, torsion, and longitudinal, circumferential, and radial systolic and diastolic strains and strain rates. Additionally, 2D-STE was performed in 14 controls.

Results: All deformational parameters on 2D-STE were significantly lower in patients with IDC compared with controls. Seven patients exhibited opposite basal (positive, counterclockwise) and 11 patients exhibited opposite apical (negative, clockwise) rotation at end-systole. Circumferential, radial, and longitudinal early diastolic strain rates were correlated most strongly with the corresponding spatial components of systolic deformation.

Conclusion: In patients IDC, all torsional, systolic, and diastolic deformational parameters were decreased. Corresponding three-dimensional components of systolic and diastolic deformations were closely coupled. Considerable variation in the direction of basal and apical rotation exists in a subset of patients with IDC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiomyopathy, Dilated / complications
  • Cardiomyopathy, Dilated / diagnostic imaging*
  • Echocardiography, Doppler / methods*
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Torsion Abnormality / complications
  • Torsion Abnormality / diagnostic imaging*
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / diagnostic imaging*