Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T05:21:40.972Z Has data issue: false hasContentIssue false
  • English
  • Français

Left ventricular rotation and right–left ventricular interaction in congenital heart disease: the acute effects of interventional closure of patent arterial ducts and atrial septal defects*

Published online by Cambridge University Press:  29 July 2013

Kai T. Laser ,
Nikolaus A. Haas ,
Markus Fischer ,
Sheeraz Habash ,
Franziska Degener ,
Christian Prinz ,
Hermann Körperich ,
Eugen Sandica  and
Deniz Kececioglu
Kai T. Laser*
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Nikolaus A. Haas
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Markus Fischer
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Sheeraz Habash
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Franziska Degener
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Christian Prinz
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Hermann Körperich
Affiliation:
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Eugen Sandica
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Deniz Kececioglu
Affiliation:
Center for Congenital Heart Defects, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
*
Correspondence to: K. T. Laser, MD, Center for Congenital Heart Defects, Heart and Diabetes Center, Northrhine-Westfalia, Ruhr-University of Bochum, Georgstr 11, D-32545 Bad Oeynhausen, Germany. Tel: +49 (0)5731 97 3637; Fax: +49 (0)5731 97 2131; E-mail: tlaser@hdz-nrw.de
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Left ventricular rotation is physiologically affected by acute changes in preload. We investigated the acute effect of preload changes in chronically underloaded and overloaded left ventricles in children with shunt lesions.

Methods

A total of 15 patients with atrial septal defects (Group A: 7.4 ± 4.7 years, 11 females) and 14 patients with patent arterial ducts (Group B: 2.7 ± 3.1 years, 10 females) were investigated using 2D speckle-tracking echocardiography before and after interventional catheterisation. The rotational parameters of the patient group were compared with those of 29 matched healthy children (Group C).

Results

Maximal torsion (A: 2.45 ± 0.9°/cm versus C: 1.8 ± 0.8°/cm, p < 0.05), apical peak systolic rotation (A: 12.6 ± 5.7° versus C: 8.7 ± 3.5°, p < 0.05), and the peak diastolic torsion rate (A: −147 ± 48°/second versus C: −110 ± 31°/second, p < 0.05) were elevated in Group A and dropped immediately to normal values after intervention (maximal torsion 1.5 ± 1.1°/cm, p < 0.05, apical peak systolic rotation 7.2 ± 4.1°, p < 0.05, and peak diastolic torsion rate −106 ± 35°/second, p < 0.05). Patients in Group B had decreased maximal torsion (B: 1.8 ± 1.1°/cm versus C: 3.8 ± 1.4°/cm, p < 0.05) and apical peak systolic rotation (B: 8.3 ± 6.1° versus C: 13.9 ± 4.3°, p < 0.05). Defect closure was followed by an increase in maximal torsion (B: 2.7 ± 1.4°/cm, p < 0.05) and the peak diastolic torsion rate (B: −133 ± 66°/second versus −176 ± 84°/second, p < 0.05).

Conclusions

Patients with chronically underloaded left ventricles compensate with an enhanced apical peak systolic rotation, maximal torsion, and quicker diastolic untwisting to facilitate diastolic filling. In patients with left ventricular dilatation by volume overload, the peak systolic apical rotation and the maximal torsion are decreased. After normalisation of the preload, they immediately return to normal and diastolic untwisting rebounds. These mechanisms are important for understanding the remodelling processes.

Keywords

Congenital heart diseasepreloadechocardiographyshunttorsion
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 4 , August 2014 , pp. 661 - 674
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This paper was presented at Poster 45th Annual Meeting of the Association for European Paediatric Cardiology, May 18–21, 2011 Granada, Spain; and Oral presentation 47th Annual meeting of the Japanese Society of Pediatric Cardiology and Cardiac Surgery, 2011 Fukuoka, Japan

References

1. Brodin, LA. Tissue doppler, a fundamental tool for parametric imaging. Clin Physiol Funct Imaging 2004; 24: 147–155.CrossRefGoogle Scholar
2. Van de Veire, NR, De Sutter, J, Bax, JJ, et al. Technological advances in tissue doppler imaging echocardiography. Heart 2008; 94: 1065–1074.Google Scholar
3. Risum, N, Ali, S, Olsen, NT, et al. Variability of global left ventricular deformation analysis using vendor dependent and independent two-dimensional speckle-tracking software in adults. J Am Soc Echocardiogr 2012; 25: 1195–1203.Google Scholar
4. Sitia, S, Tomasoni, L, Turiel, M. Speckle tracking echocardiography: a new approach to myocardial function. World J Cardiol 2010; 2: 1–5.Google Scholar
5. Nakatani, S. Left ventricular rotation and twist: why should we learn? J Cardiovasc Ultrasound 2011; 19: 1–6.Google Scholar
6. Buchalter, MB, Weiss, JL, Rogers, WJ, et al. Noninvasive quantification of left ventricular rotational deformation in normal humans using magnetic resonance imaging myocardial tagging. Circulation 1990; 81: 1236–1244.Google Scholar
7. Helle-Valle, T, Crosby, J, Edvardsen, T, et al. New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 2005; 112: 3149–3156.Google Scholar
8. Notomi, Y, Lysyansky, P, Setser, RM, et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 2005; 45: 2034–2041.Google Scholar
9. Notomi, Y, Setser, RM, Shiota, T, et al. Assessment of left ventricular torsional deformation by doppler tissue imaging: validation study with tagged magnetic resonance imaging. Circulation 2005; 111: 1141–1147.Google Scholar
10. Buckberg, G, Hoffman, JIE, Nanda, NC, et al. Ventricular torsion and untwisting: further insights into mechanics and timing interdependence: a viewpoint. Echocardiography 2011; 28: 782–804.CrossRefGoogle ScholarPubMed
11. Dong, SJ, Hees, PS, Huang, WM, et al. Independent effects of preload, afterload, and contractility on left ventricular torsion. Am J Physiol 1999; 277: H1053–H1060.Google Scholar
12. Hansen, DE, Daughters, GT II, Alderman, EL, et al. Effect of volume loading, pressure loading, and inotropic stimulation on left ventricular torsion in humans. Circulation 1991; 83: 1315–1326.Google Scholar
13. Moon, MR, Ingels, NB Jr, Daughters, GT II, et al. Alterations in left ventricular twist mechanics with inotropic stimulation and volume loading in human subjects. Circulation 1994; 89: 142–150.Google Scholar
14. Weiner, RB, Weyman, AE, Khan, AM, et al. Preload dependency of left ventricular torsion: the impact of normal saline infusion. Circ Cardiovasc Imaging 2010; 3: 672–678.Google Scholar
15. Mathew, R, Thilenius, OG, Arcilla, RA. Comparative response of right and left ventricles to volume overload. Am J Cardiol 1976; 38: 209–217.Google Scholar
16. Eerola, A, Jokinen, E, Boldt, T, et al. The influence of percutaneous closure of patent ductus arteriosus on left ventricular size and function: a prospective study using two- and three-dimensional echocardiography and measurements of serum natriuretic peptides. J Am Coll Cardiol 2006; 47: 1060–1066.CrossRefGoogle ScholarPubMed
17. Ewert, P, Berger, F, Nagdyman, N, et al. Acute left heart failure after interventional occlusion of an atrial septal defect. Z Kardiol 2001; 90: 362–366.Google Scholar
18. Jeong, YH, Yun, TJ, Song, JM, et al. Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure. Am Heart J 2007; 154: 436–440.Google Scholar
19. Notomi, Y, Srinath, G, Shiota, T, et al. Maturational and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. Circulation 2006; 113: 2534–2541.Google Scholar
20. Laser, KT, Haas, NA, Jansen, N, et al. Is torsion a suitable echocardiographic parameter to detect acute changes in left ventricular afterload in children? J Am Soc Echocardiogr 2009; 22: 1121–1128.Google Scholar
21. Streeter, D. Gross morphology and fiber geometry of the heart. In: Berne R (ed.). Handbook of Physiology. Williams and Wilkins, Baltimore, 1979: 61–112.Google Scholar
22. Streeter, DD, Powers, WE, Ross, MA, et al. Three dimensional fiber orientation in the mammalian left ventricle wall. In: Baan J, Noordergraaf A, and Raines J (eds). Cardiovascular System Dynamics. MIT Press, Cambridge, MA, 1978: 73–84.Google Scholar
23. Torrent-Guasp, F, Buckberg, GD, Clemente, C, et al. The structure and function of the helical heart and its buttress wrapping. I. The normal macroscopic structure of the heart. Semin Thorac Cardiovasc Surg 2001; 13: 301–319.CrossRefGoogle ScholarPubMed
24. Kocica, MJ, Corno, AF, Carreras-Costa, F, et al. The helical ventricular myocardial band: global, three-dimensional, functional architecture of the ventricular myocardium. Eur J Cardiothorac Surg 2006; 29 (Suppl 1): S21–S40.Google Scholar
25. Lunkenheimer, PP, Redmann, K, Westermann, P, et al. The myocardium and its fibrous matrix working in concert as a spatially netted mesh: a critical review of the purported tertiary structure of the ventricular mass. Eur J Cardiothorac Surg 2006; 29 (Suppl 1): S41–S49.Google Scholar
26. Masutani, S, Senzaki, H. Left ventricular function in adult patients with atrial septal defect: implication for development of heart failure after transcatheter closure. J Card Fail 2011; 17: 957–963.CrossRefGoogle ScholarPubMed
27. Stern, H, Baurecht, H, Luechinger, R, et al. Does the amplatzer septal occluder device alter ventricular contraction pattern? A ventricular motion analysis by mr tagging. J Magn Reson Imaging 2012; 35: 949–956.Google Scholar
28. Dong, L, Zhang, F, Shu, X, et al. Left ventricular torsional deformation in patients undergoing transcatheter closure of secundum atrial septal defect. Int J Cardiovasc Imaging 2009; 25: 479–486.Google Scholar
29. Jin, SM, Noh, CI, Bae, EJ, et al. Decreased left ventricular torsion and untwisting in children with dilated cardiomyopathy. J Korean Med Sci 2007; 22: 633–640.Google Scholar
30. Kanzaki, H, Nakatani, S, Yamada, N, et al. Impaired systolic torsion in dilated cardiomyopathy: reversal of apical rotation at mid-systole characterized with magnetic resonance tagging method. Basic Res Cardiol 2006; 101: 465–470.Google Scholar
31. Gupta, SK, Krishnamoorthy, K, Tharakan, JA, et al. Percutaneous closure of patent ductus arteriosus in children: immediate and short-term changes in left ventricular systolic and diastolic function. Ann Pediatr Cardiol 2011; 4: 139–144.Google Scholar
32. van der Hulst, AE, Delgado, V, Holman, ER, et al. Relation of left ventricular twist and global strain with right ventricular dysfunction in patients after operative “correction” of tetralogy of fallot. Am J Cardiol 2010; 106: 723–729.CrossRefGoogle ScholarPubMed
33. Cheung, YF, Wong, SJ, Liang, XC, et al. Torsional mechanics of the left ventricle in patients after surgical repair of tetralogy of fallot. Circ J 2011; 75: 1735–1741.Google Scholar
34. Pettersen, E, Helle-Valle, T, Edvardsen, T, et al. Contraction pattern of the systemic right ventricle shift from longitudinal to circumferential shortening and absent global ventricular torsion. J Am Coll Cardiol 2007; 49: 2450–2456.Google Scholar
35. Cameli, M, Ballo, P, Righini, FM, et al. Physiologic determinants of left ventricular systolic torsion assessed by speckle tracking echocardiography in healthy subjects. Echocardiography 2011; 28: 641–648.Google Scholar