Left ventricular twist mechanics in the context of normal physiology and cardiovascular disease

a review of studies using speckle tracking echocardiography

authored by: Eric J. Stöhr, Rob E. Shave, Aaron L. Baggish, Rory B. Weiner
Abstract: The anatomy of the adult human left ven tricle (LV) is the result of its complex interaction with its environment. From the fetal to the neonatal to the adult form, the human LV undergoes an anatomical transformation that finally results in the most complex of the four cardiac chambers. In its adult form, the human LV consists of two muscular helixes that surround the midventricular circumferential layer of muscle fibers. Contraction of these endocardial and epicardial helixes results in a twisting motion that is thought to minimize the transmural stress of the LV muscle. In the healthy myocardium, the LV twist response to stimuli that alter preload, afterload, or contractility has been described and is deemed relatively consistent and predictable. Conversely, the LV twist response in patient populations appears to be a little more variable and less predictable, yet it has revealed important insight into the effect of cardiovascular disease on LV mechanical function. This review discusses important methodological aspects of assessing LV twist and evaluates the LV twist responses to the main physiological and pathophysiological states. It is concluded that correct assessment of LV twist mechanics holds significant potential to advance our understanding of LV function in human health and cardiovascular disease.
External Organisation(s): Cardiff Metropolitan University
Massachusetts General Hospital
Type: Review article
Journal: American Journal of Physiology - Heart and Circulatory Physiology
Volume: 311
Pages: H633-H644
ISSN: 0363-6135
Publication date: 09.2016
Publication status: Published
Peer reviewed: Yes
ASJC Scopus subject areas: Physiology, Cardiology and Cardiovascular Medicine, Physiology (medical)
Sustainable Development Goals: SDG 3 - Good Health and Well-being
Electronic version(s): https://doi.org/10.1152/ajpheart.00104.2016 (Access: Open)